阴道分娩产后显性尿潴留的危险因素分析  

Analysis of risk factors for overt postpartum urinary retention after vaginal delivery

作　　者：董留琛 谢明坤[2] 李根霞[2] 陈长英[1,3] DONG Liu-chen;XIE Ming-kun;LI Gen-xia;CHEN Chang-ying(School of Nursing and Health,Zhengzhou University,Zhengzhou 450001,China;The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Quality Control,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学护理与健康学院,郑州450052 [2]郑州大学第三附属医院,郑州450052 [3]郑州大学第一附属医院质量控制科,郑州450052

出　　处：《医药论坛杂志》2023年第11期1-5,10,共6页Journal of Medical Forum

基　　金：河南省科技攻关计划(172102310399)。

摘　　要：目的分析阴道分娩产后显性尿潴留(postpartum urinary retention,PUR)的危险因素,为高危产妇早期识别和干预提供理论依据。方法选取2020年6月至2021年5月在郑州大学第三附属医院经阴道分娩的5418例产妇为研究对象,发生显性PUR的233例为尿潴留组,随机选取同期未发生尿潴留的560例产妇作为对照组,采用logistic回归分析研究阴道分娩显性尿潴留的危险因素。结果阴道分娩产后显性尿潴留的发病率为4.30%,通过单因素分析,高龄、初产妇、子宫肌瘤、水囊引产、缩宫素引产、羊水污染、产程中使用缩宫素加强宫缩、椎管内麻醉、产时静脉补液、产程中间断一次性导尿、产时发热、第一产程时间、第二产程时间、总产程时间、会阴部麻醉方式、会阴部损伤情况、子宫颈裂伤、会阴水肿、阴道血肿、产后出血、巨大儿、产后即刻母婴分离是阴道分娩显性PUR的危险因素(P<0.05)。通过多因素回归分析,水囊引产、产程中使用缩宫素加强宫缩、椎管内麻醉镇痛、产时静脉补液、第二产程时间、会阴损伤情况、子宫颈裂伤、产后即刻母婴分离是阴道分娩显性PUR的独立危险因素(P<0.05)。尿潴留组住院天数明显长于对照组住院天数(5.65±2.67 vs 4.27±2.28,P<0.001)。结论产时、产后多种因素会增加阴道分娩产后显性尿潴留的发生风险,应早期识别高危人群,采取相应的预防措施来减少尿潴留的发生。Objective To analyze the risk factors of overt postpartum urinary retention(PUR)after vaginal delivery,so as to provide a theoretical basis for early identification and intervention of high-risk pregnant women.Methods Total-ly 5418 vaginal delivery in the Third Affiliated Hospital of Zhengzhou University from June 2020 to May 2021 were se-lected as the research object,233 cases with overt PUR were selected as the urinary group,and 560 pregnant women who did not have urinary retention in the same period were randomly selected as the control group.Logistic regression a-nalysis was used to study the risk factors of overt urinary retention in vaginal delivery.Results The incidence rate of o-vert urinary retention after vaginal delivery was 4.30%.Through univariate analysis,the age,primipara,hysteromyo-ma,water sac induced labor,oxytocin induced labor,amniotic fluid pollution,oxytocin used during labor to strengthen uterine contraction,intraspinal anesthesia,intrapartum venous rehydration,one-time catheterization during labor,in-trapartum fever,time of the first labor process,time of the second labor process,time of the total labor process,method of perineal anesthesia,perineal injury,cervical laceration,perineal edema,vaginal hematoma,postpartum hemorrhage macrosomia,and immediate postpartum mother infant separation were the risk factors for overt PUR(P<0.05).Multi-variate regression analysis showed that water sac induced labor,oxytocin used to strengthen uterine contraction during la-bor,intraspinal anesthesia and analgesia,intravenous rehydration during labor,time of the second labor process,peri-neal injury,cervical laceration,and immediate mother infant separation after delivery were independent risk factors for dominant pur in vaginal delivery(P<0.05).The length of stay in the urinary retention group was significantly longer than that of the control group(5.65±2.67 vs 4.27±2.28,P<0.001).Conclusion Many factors during and after childbirth could increase the risk of overt urinary retention after vaginal delivery

关 键 词：阴道分娩 产后尿潴留 显性 危险因素 

分 类 号：R714.64[医药卫生—妇产科学]