适时诱导干预对阴道分娩初产妇产后排尿效果的影响  

Effect of timely induction intervention on postpartum urination of primipara in vaginal delivery

作　　者：郭丹 凌敏 王子敬 毕嫣 史惠晶 刘晓艳 丛丰辉 Guo Dan;Ling Min;Wang Zijing;Bi Yan;Shi Huijing;Liu Xiaoyan;Cong Fenghui(Department of Obstetric,Dalian Women and Children's Medical Group Sports New Town Hospital,Dalian 116037,China;Quality Control Center,Dalian Railway Medical School,Dalian 116000,China;Department of Nursing,Dalian Women and Children's Medical Group Sports New Town Hospital,Dalian 116037,China)

机构地区：[1]大连市妇女儿童医疗中心(集团)体育新城院区产科,大连116037 [2]大连铁路卫生学校质控中心,大连116000 [3]大连市妇女儿童医疗中心(集团)体育新城院区护理部,大连116037

出　　处：《中国实用护理杂志》2024年第6期401-406,共6页Chinese Journal of Practical Nursing

基　　金：大连市医学科学研究计划项目资助(2111031)。

摘　　要：目的探讨适时诱导干预对阴道分娩初产妇产后排尿效果的影响,为临床有效预防阴道分娩初产妇产后尿潴留的发生,减轻产妇痛苦提供依据。方法采用随机对照试验设计,便利抽样法选取2021年6月至2022年9月大连市妇女儿童医疗中心(集团)体育新城院区产科收治行阴道分娩的初产妇400例作为研究对象,采用随机数字表法分为干预组和对照组各200例。对照组产妇采取常规的产后护理,指导产后6 h内主动排尿;干预组产妇采用适时诱导排尿干预,分别于产后2、4、6 h进行一般状况和膀胱尿量评估,并实施个性化的指导,包括按摩宫底的频率、饮水量的控制、诱导排尿的方法和时机的选择等,至产妇完成首次排尿且无不适主诉时,给予常规的产后护理。比较2组产妇产后首次排尿时间、首次排尿量、首次排尿有无膀胱刺激征及产后不同时段尿潴留的发生率。结果对照组年龄(29.60±3.20)岁,干预组年龄(28.81±3.42)岁。干预组产妇产后首次排尿时间为(6.89±2.18)h,短于对照组的(9.11±3.86)h,差异有统计学意义(t=-2.49,P<0.01);干预组产妇产后首次排尿量为(322.36±120.15)ml,多于对照组的(262.93±105.68)ml,差异有统计学意义(t=3.39,P<0.05);干预组产妇首次排尿膀胱刺激征发生率为22.0%(44/200),低于对照组的33.5%(67/200),差异有统计学意义(χ^(2)=6.60,P<0.05);干预组产妇产后24 h内尿潴留发生率为5.5%(11/200),低于对照组的11.5%(23/200),差异有统计学意义(χ^(2)=4.63,P<0.05);干预组产妇产后1周内尿潴留发生率为9.5%(19/200),低于对照组的16.5%(33/200),差异有统计学意义(χ^(2)=4.33,P<0.05),但2组产妇产后24~72 h尿潴留的发生率比较差异无统计学意义(P>0.05)。结论采用适时诱导干预可降低阴道分娩初产妇产后尿潴留的发生率,缩短首次排尿时间,增加产后首次排尿量,提高首次排尿舒适度,值得临床推广应用。Objective To explore the effect of timely induction intervention on postpartum urination in primipara during vaginal delivery,so as to provide the evidence for preventing the occurrence of postpartum urinary retention and relieving the pain of primipara.Methods This study adopted a randomized controlled trial design,and selected 400 cases of primipara who were hospitalized for vaginal delivery in the Obstetric Department of Dalian Women and Children's Medical Group Sports New Town Hospital from June 2021 to September 2022 as the study objects by convenience sampling method.They were divided into the intervention group and the control group with 200 cases each by random number table method,and the control group received routine postpartum care.Instruct active urination within 6 hours after delivery.The intervention received timely induction urination intervention.The general condition and bladder urine volume of the women in the intervention group were evaluated at 2,4,6 h after delivery,respectively,and personalized guidance was implemented,including the frequency of massage of the bottom of the uterus,the control of water intake,the selection of methods and timing of inducing urination,etc.,and routine postpartum care was given when the women completed their first urination and had no complaints of discomfort.The first urination time,first urination volume,first bladder irritation during the first urination and the incidence of postpartum urinary retention in different periods were compared between the two groups.Results The patients in the control group were(29.60±3.20)years old,while the patients in the intervention group were(28.81±3.42)years old.The first urination time in the intervention group was(6.89±2.18)h,which was shorter than that in the control group(9.11±3.86)h,and the difference was statistically significant(t=-2.49,P<0.01).The first urination volume in the intervention group was(322.36±120.15)ml,which was higher than that in the control group(262.93±105.68)ml,and the difference was statisti

关 键 词：尿潴留 初产妇 适时诱导 首次排尿 

分 类 号：R473.71[医药卫生—护理学]