硬膜外镇痛阴道分娩产妇产后尿潴留危险因素分析  

Analysis of the risk factors of the postpartum urinary retention of women undergone the vaginal painless delivery under epidural analgesia

作　　者：李琪 徐林军 单春燕 王艳 徐倩娟 LI Qi;XU Linjun;SHAN Chunyan;WANG Yan;XU Qianjuan(Hangzhou Obstetrics and Gynecology Hospital,Hangzhou,Zhejiang Province,310008)

机构地区：[1]浙江省杭州市妇产科医院,310008

出　　处：《中国计划生育学杂志》2025年第4期980-983,共4页Chinese Journal of Family Planning

基　　金：浙江省医药卫生科技计划项目(2024KY226)。

摘　　要：目的:探讨硬膜外分娩镇痛产后尿潴留(PUR)的危险因素。方法:回顾性分析本院行硬膜外分娩镇痛的1605例自然分娩产妇临床资料,根据是否发生PUR分为PUR组(143例)和非PUR组(1462例),采用单因素及logistic回归分析硬膜外分娩镇痛产妇PUR发生的影响因素。结果:1605例产妇PUR发生率为8.9%。logistic回归分析显示第二产程延长(OR=1.877,95%CI 1.096~3.209)、产钳助产(OR=4.095,95%CI 1.752~9.570)、会阴侧切(OR=2.740,95%CI 1.377~5.452)、会阴≥Ⅱ度裂伤(OR=3.108,95%CI 1.505~6.419)、硬膜外镇痛时长(OR=1.465,95%CI 1.055~2.036)、使用缩宫素(OR=2.038,95%CI 1.120~3.705)、巨大儿(OR=2.152,95%CI 1.154~4.012)、间歇导尿次数(OR=0.459,95%CI 0.256~0.819)是无痛分娩产妇发生PUR的独立影响因素。结论:硬膜外分娩镇痛产妇PUR的发生与第二产程延长、产钳助产、会阴裂伤、会阴侧切、硬膜外麻醉时长、使用缩宫素、分娩巨大儿是PUR的危险因素,临床应制定有针对性的方案,以减少PUR的发生。Objective:To explore the risk factors of the postpartum urinary retention(PUR)of women undergone the vaginal painless delivery under epidural analgesia.Methods:The clinical data of 1605 women who had experienced the vaginal painless delivery under epidural analgesia in the hospital were analyzed retrospectively.These women were divided into group A(143 cases with PUR)and group B(1462 cases without PUR)according to the PUR of the women occurred or not.The risk factor of the PUR occurred of the women who had experienced the vaginal painless delivery under epidural analgesia was analyzed by univariate analysis and logistic regression analysis.Results:The incidence of the maternal PUR in 1605 women was 8.9%.Logistic regression analysis showed that the prolonged second stage of labor(OR=1.877,95%CI 1.096-3.209),the forceps midwifery(OR=4.095,95%CI 1.752-9.570),the perineal lateral incision(OR=2.740,95%CI 1.377-5.452),the perineal laceration≥Ⅱ(OR=3.108,95%CI 1.505-6.419),the prolonged epidural analgesia(OR=1.465,95%CI 1.055-2.036),the treated with dioxytocin(OR=2.038,95%CI 1.120-3.705),the delivery of macrosomia(OR=2.152,95%CI 1.154-4.012)and the intermittent catheterization(OR=0.459,95%CI 0.256-0.819)of the women with epidural analgesia for vaginal painless delivery were the independent factors influencing their PUR occurrence.Conclusion:The occurrence of PUR of the women with the epidural analgesia for vaginal painless delivery is related to their prolonged second stage of labor,forceps midwifery,perineal laceration,perineal lateral incision,long time of epidural anesthesia,oxytocin used and macrosomia delivery.So the targeted management plan should be formulated to reduce the occurrence of PUR of these women.

关 键 词：硬膜外镇痛 阴道分娩 产后尿潴留 影响因素 

分 类 号：R714.3[医药卫生—妇产科学]