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目的调查单胎阴道分娩产妇产后尿潴留(Postpartum urinary retention,PPUR)发生特点及其与产科参数的关系,以期为PPUR的临床护理提供数据支持。方法 155例阴道分娩的产妇,排尿后膀胱残余容积(postvoid residual urine volume,PVRV)≥150 mL的患者纳入PPUR组,<150 mL的患者纳入非PPUR组,比较组间的人口学资料和产科参数之间的差异,考察上述参数与PVRV的相关性。结果经阴道顺产产妇PPUR总发生率为7.7%,其中显性(不能自主排尿)和隐性(能自主排尿但排尿后PPUR≥150 mL)PPUR发生率均为3.35%。对于单因素分析有意义的自变量进行Logistic回归分析发现,初产、第二产程>1 h、硬膜外麻醉、会阴切开术、器械分娩和会阴疼痛评分>2分是发生产后尿潴留的独立危险因素。结论如产妇属于初产且分娩过程中出现第二产程延长、硬膜外镇痛、会阴切开术、器械分娩和会阴疼痛中的1种或几种情况时,要进行B超排查隐性PPUR。可采用音乐、心理、流水声刺激等无创的干预方式,避免患者发生产后尿潴留。
Abstract：Objective To investigate the occurrence characteristics of Postpartum urinary retention(PPUR) and its relationship with various obstetric parameters in single vaginal delivery, in order to provide data support for PPUR clinical nursing. Methods Among the 155 parturients in vaginal delivery, patients with postvoid residual urine volume(PVRV) ≥150 mL were included in study group, and patients with <150 mL were included in control group. The differences in demographic data and obstetric parameters between the groups were compared to investigate the correlation between the above parameters and PVRV. Results The total incidence of PPUR in vaginal delivery women was 7.7%, in which the incidence of PPUR in dominance(unable to urinate autonomously) and recessiveness(able to urinate autonomously but PPUR≥150 mL after urination) was 3.35%. Logistic regression analysis of significant independent variables for univariate analysis showed that primary labor, secondary labor stage >1 h, epidural analgesia, perineotomy, instrument delivery and perineal pain score >2 were independent risk factors for postpartum urinary retention. Conclusion For women with a high score of first or second labor, epidural analgesia, perineotomy, instrument delivery and perineal pain, attention should be paid to screening patients with negative urinary retention after delivery.
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基本信息:
中图分类号:R473.71
引用信息:
[1]万秋园,赵艳,冯晓姗,等.单胎顺产后尿潴留发生特点及其与产科参数的相关性[J].新疆医科大学学报,2020,43(05):611-614.
基金信息:
陕西省重点研发计划项目(2019SF-048)
2020-05-15
2020-05-15