基于发生风险列线图模型的综合干预在阴道分娩后发生尿潴留患者中的应用价值  

Application of Comprehensive Intervention Based on Risk Nomogram Model in Patients with Urinary Retention after Vaginal Delivery

作　　者：陈立琴[1] 殷盛娴 CHEN Li-qin;YIN Sheng-xian(Department of Obstetrics and Gynecology,Changshu Hospital of Traditional Chinese Medicine(New Area Hospital),Changshu Jiangsu 215500)

机构地区：[1]常熟市中医院(新区医院)妇产科,江苏常熟215500

出　　处：《医学临床研究》2022年第2期244-247,共4页Journal of Clinical Research

摘　　要：【目的】探讨基于发生风险列线图模型的综合干预在阴道分娩后发生尿潴留患者中的应用价值。【方法】回顾性分析2018年1月至2019年3月在本院诊治的856例阴道分娩产妇的临床资料,根据是否发生尿潴留分为尿潴留组(n=62)与正常组(n=794),采用Logistics回归模型筛选阴道分娩后发生尿潴留的危险因素,将筛选出的各危险因素建立列线图预测模型。前瞻性研究中,选取2019年5月至10月在本院诊治的173例阴道分娩产妇,按照随机数表法分为观察组和对照组,观察组实施基于发生风险列线图预测模型的综合干预,对照组实施常规干预,对比两组产后自行排尿时间、尿潴留发生率、产后2 h出血量与产后6 h残余尿量。【结果】回顾性分析显示:阴道分娩产后尿潴留发生率为7.24%(62/856);Logistic回归分析显示:分娩镇痛、产钳助产、手转胎头、第一产程时间、第二产程时间均为阴道分娩后发生尿潴留的独立危险因素(P<0.05)。根据筛选出的阴道分娩后发生尿潴留的危险因素构建列线图预测模型,采用ROC曲线评估列线图区分度,ROC曲线下面积0.790,校准曲线斜率接近于1,区分度与准确度良好。前瞻性研究中,观察组自行排尿时间短于对照组,尿潴留发生率低于对照组,其差异有统计学意义(P<0.05);观察组产后2 h出血量与产后6 h残余尿量均少于对照组(P<0.05)。【结论】基于发生风险列线图预测模型的综合干预有助于预防阴道分娩后发生尿潴留,减少产后出血量与残余尿量,值得临床推广应用。【Objective】To explore the value of comprehensive intervention based on risk nomogram model in patients with urinary retention after vaginal delivery.【Methods】The clinical data of 856 cases of vaginal delivery in our hospital from January 2018 to March 2019 were retrospectively analyzed.According to whether urinary retention occurred or not,they were divided into urinary retention group(n=62)and normal group(n=794),logistics regression model was used to screen the risk factors of urinary retention after vaginal delivery.In a prospective study,173 cases of vaginal delivery women who were diagnosed and treated in our hospital from May 2019 to October 2019 were randomly divided into observation group and control group.The observation group received comprehensive intervention based on risk line chart prediction model,while the control group received routine intervention.The time of self urination,incidence of urinary retention,postpartum hemorrhage of 2 h and residual urine volume of 6 h after delivery were compared between the two groups.【Results】A retrospective analysis showed that the incidence of postpartum urinary retention was 7.24%(62/856).Logistic regression analysis showed that labor analgesia,forceps delivery,hand to head transfer,first stage of labor and second stage of labor were independent risk factors for urinary retention after vaginal delivery(P<0.05).According to the risk factors of urinary retention after vaginal delivery,a nomogram prediction model was constructed.The ROC curve was used to evaluate the nomogram of the nomogram,the area under the ROC curve was 0.790,the slope of the calibration curve was close to 1,and the discrimination and accuracy were good.In the prospective study,the time of self urination in the observation group was shorter than that in the control group,and the incidence of urinary retention was lower than that in the control group(P<0.05).The amount of postpartum hemorrhage at 2 hours and residual urine at 6 hours in the observation group were less than those in

关 键 词：自然分娩 产褥期疾病/预防和控制 尿潴留/预防和控制 风险调节 

分 类 号：R694.550.58[医药卫生—泌尿科学]