[1]刘 岩,刘 永.剖宫产产妇硬膜外麻醉术后发生尿储留的危险因素分析[J].医学信息,2020,33(11):111-113.[doi:10.3969/j.issn.1006-1959.2020.11.034]
　LIU Yan,LIU Yong.Analysis of Risk Factors for Urinary Retention After Epidural Anesthesia for Cesarean Section[J].Medical Information,2020,33(11):111-113.[doi:10.3969/j.issn.1006-1959.2020.11.034]
点击复制

剖宫产产妇硬膜外麻醉术后发生尿储留的危险因素分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年11期
页码:
111-113
栏目:
临床研究
出版日期:
2020-06-01

文章信息/Info

Title:
Analysis of Risk Factors for Urinary Retention After Epidural Anesthesia for Cesarean Section
文章编号:
1006-1959（2020）11-0111-03
作者:
刘 岩; 刘 永
（天津港口医院麻醉科，天津 300456）
Author(s):
LIU Yan; LIU Yong
(Department of Anesthesiology,Tianjin Port Hospital,Tianjin 300456,China)
关键词:
剖宫产; 硬膜外麻醉; 尿滞留; 危险因素; 防治措施
Keywords:
Cesarean section; Epidural anesthesia; Urine retention; Risk factors; Preventive measures
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2020.11.034
文献标志码:
A
摘要:
目的 探讨行硬膜外麻醉剖宫产的产妇发生产后尿滞留（PUR）的危险因素及防治措施。方法 选取2019年1~6月我院硬膜外麻醉下行剖宫产手术的产妇247例，根据产后尿滞留情况分为PUR组和非PUR组，比较两组临床资料，并采用多Logistic回归分析发生PUR的影响因素。结果 单因素分析显示，两组产妇产前内检次数、产程较长、产后正常饮水、产后心理因素、产后生活习惯、定时夹管比较，差异有统计学意义（P＜0.05）；两组年龄、文化程度、BMI、泌尿系统疾病史、高血脂、高血压、糖尿病、单胎妊娠、输血等资料比较，差异无统计学意义（P＞0.05）。多因素Logistic回归分析显示，产前内检次数（OR=5.168，95%CI：1.104~24.191）、产程较长（OR=2.439，95%CI：1.114~5.340）、产后心理因素（OR=2.863，95%CI：1.266~6.475）是发生PUR的独立危险因素；产后正常饮水（OR=0.390，95%CI：0.176~0.864）、适应产后生活习惯（OR=0.352，95%CI：0.160~0.776）及定时夹管（OR=0.393，95%CI：0.175~0.884）是发生PUR的保护性因素。结论 产前内检次数、产程较长、产后心理因素是剖宫产产妇硬膜外麻醉术后发生PUR的独立危险因素。产后正常饮水、适应产后生活习惯及定时夹管能有效降低PUR的发生率，临床应注意筛查和管理危险因素，积极制定和实施相关干预措施。
Abstract:
Objective To explore the risk factors and preventive measures of postpartum urinary retention (PUR) in women undergoing epidural anesthesia for cesarean section.Methods A total of 247 women who had undergone cesarean section under epidural anesthesia in our hospital from January to June 2019 were selected, according to postpartum urine retention, it was divided into PUR group and non-PUR group, the clinical data of the two groups were compared, and multiple Logistic regression was used to analyze the influencing factors of PUR.Results Univariate analysis showed that there were statistically significant differences between the two groups in the number of prenatal internal examinations, longer labor duration, normal postpartum drinking water, postpartum psychological factors, postpartum lifestyle habits, and regular pinch control,the difference was statistically significant (P<0.05); the age, education level, BMI, history of urinary system diseases, hyperlipidemia, hypertension, diabetes, singleton pregnancy, blood transfusion and other data were not statistically significant (P>0.05). Multivariate Logistic regression analysis showed that the number of prenatal internal inspections(OR=5.168, 95%CI:1.104~24.191), longer labor (OR=2.439, 95%CI:1.114~5.340), postpartum psychological factors (OR=2.863, 95%CI:1.266~6.475) is an independent risk factor for PUR; normal postpartum drinking water (OR=0.390, 95%CI:0.176~0.864), adapt to postpartum life habits (OR=0.352, 95%CI:0.160~0.776) and timing pinch(OR=0.393,95%CI:0.175~0.884) are protective factors for PUR.Conclusion The number of prenatal internal examinations, longer labor duration, and postpartum psychological factors are independent risk factors for PUR after epidural anesthesia in cesarean section. Normal drinking water after childbirth, adapting to postpartum life habits and regular pinching can effectively reduce the incidence of PUR. Clinical attention should be paid to screening and management of risk factors, and relevant intervention measures should be actively formulated and implemented.

参考文献/References:

[1]王淑伟.两种麻醉方式对剖宫产手术娩出新生儿安全性的影响[J].现代医学,2014,42(8):902-905.[2]范小燕,彭冰洁,梁桂英.产后尿潴留的高危因素及盆底肌训练的防治效果分析[J].海南医学,2015(23):3545-3547.[3]杨永碧.阴道分娩后尿潴留危险因素分析及盆底康复干预的作用[J].中国妇幼保健,2014(30):4911-4913.[4]姜丽杰,蔺莉.产后尿潴留的研究进展[J].中国妇产科临床杂志,2018,19(4):372-374.[5]Pannullo A,Hill A.Physical Therapy Interventions for Prolonged Postpartum Urinary Retention[J].Journal of Women’s Health Physical Therapy,2018,42(1):23-31.[6]Retention PU.Postpartum Urinary Retention[J].Obstetrics & Gynecology,2015,83(10):881-891.[7]Polat M,Sentürk MB,Pulatoglu C,et al.Postpartum urinary retention: Evaluation of risk factors[J].Turkish Journal of Obstetrics&Gynecology,2018,15(2):70-74.[8]Pifarotti P,Gargasole C,Folcini C,et al.Acute post-partum urinary retention: analysis of risk factors, a case-control study[J].Arch Gynecol Obstet,2014,289(6):1249-1253.[9]任青.产后尿潴留的危险因素及防治研究进展[J].中国临床医生杂志,2015(9):18-20.[10]徐秋菊.中西医结合治疗产后尿潴留临床观察[J].中国医疗器械信息,2015(21):423.[11]陈海平,武彦.低位钳产术产后尿潴留的发生及影响因素分析[J].护理实践与研究,2016(4):91-93.[12]Mulder FE,Schoffelmeer MA,Hakvoort RA,et al.Risk factors for postpartum urinary retention:a systematic review and meta-analysis[J].BJOG,2012,119(12):1440-1446.

相似文献/References:

[1]刘汉芬.剖宫产术后护理干预对产妇康复效果的影响分析[J].医学信息,2018,31(01):169.[doi:10.3969/j.issn.1006-1959.2018.01.067]
　LIU Han-fen.Effect of Nursing Intervention on Maternal Rehabilitation after Cesarean Section[J].Medical Information,2018,31(11):169.[doi:10.3969/j.issn.1006-1959.2018.01.067]
[2]刘 礼.影响剖宫产术后瘢痕子宫足月分娩结局的相关因素分析[J].医学信息,2018,31(02):109.[doi:10.3969/j.issn.1006-1959.2018.02.039]
　LIU Li.Analysis of Related Factors Influencing the Outcome of Full Term Delivery of Scar Uterus after Cesarean Section[J].Medical Information,2018,31(11):109.[doi:10.3969/j.issn.1006-1959.2018.02.039]
[3]李 欢,刘 俊,夏军辉.妊娠期高血压疾病患者血浆Pro BNP水平及其临床意义[J].医学信息,2018,31(04):158.[doi:10.3969/j.issn.1006-1959.2018.04.059]
　LI Huan,LIU Jun,XIA Jun-hui.Plasma Pro BNP Levels in Patients with Hypertensive Disorder Complicating Pregnancy and their Clinical Significance[J].Medical Information,2018,31(11):158.[doi:10.3969/j.issn.1006-1959.2018.04.059]
[4]鲁秋彤.经阴道彩色多普勒超声在诊断剖宫产子宫疤痕妊娠中的 价值研究[J].医学信息,2018,31(05):160.[doi:10.3969/j.issn.1006-1959.2018.05.058]
　LU Qiu-tong.The Value of Transvaginal Color Doppler Ultrasound in the Diagnosis of Cesarean Scar Pregnancy[J].Medical Information,2018,31(11):160.[doi:10.3969/j.issn.1006-1959.2018.05.058]
[5]蒋红梅.子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中 胎盘剥离面出血的临床研究[J].医学信息,2018,31(07):120.[doi:10.3969/j.issn.1006-1959.2018.07.040]
　JIANG Hong-mei.Clinical Study on the Treatment of Placental Exfoliation Bleeding in Caesarean Section of Placenta Previa by Transverse Annular Compression Suture of Lower Uterine Segment[J].Medical Information,2018,31(11):120.[doi:10.3969/j.issn.1006-1959.2018.07.040]
[6]冉会仁.小剂量舒芬太尼在剖宫产术麻醉中预防寒战及 牵拉痛的疗效评价[J].医学信息,2018,31(08):101.[doi:10.3969/j.issn.1006-1959.2018.08.032]
　RAN Hui-ren.Evaluation of the Efficacy of Low-dose Sufentanil in Preventing Chills and Pulling Pain during Cesarean Section Anesthesia[J].Medical Information,2018,31(11):101.[doi:10.3969/j.issn.1006-1959.2018.08.032]
[7]王玉霞.剖宫产术后子宫疤痕妊娠的临床诊治[J].医学信息,2018,31(10):48.[doi:10.3969/j.issn.1006-1959.2018.10.015]
　WANG Yu-xia.Clinical Diagnosis and Treatment of Uterine Scar Pregnancy after Cesarean Section[J].Medical Information,2018,31(11):48.[doi:10.3969/j.issn.1006-1959.2018.10.015]
[8]龙俊青.臀位外倒转术的应用研究[J].医学信息,2019,32(12):61.[doi:10.3969/j.issn.1006-1959.2019.12.019]
　LONG Jun-qing.Application Study of Breech Presentation[J].Medical Information,2019,32(11):61.[doi:10.3969/j.issn.1006-1959.2019.12.019]
[9]邢 均.全身麻醉联合硬膜外麻醉在宫颈癌手术中的应用及效果评价[J].医学信息,2019,32(01):122.[doi:10.3969/j.issn.1006-1959.2019.01.037]
　XING Jun.Application and Evaluation of General Anesthesia Combined with Epidural Anesthesia in[J].Medical Information,2019,32(11):122.[doi:10.3969/j.issn.1006-1959.2019.01.037]
[10]熊 丽,蒋明珉,何娅娟.以护士为主导的疼痛管理模式在剖宫产围手术期的应用研究[J].医学信息,2019,32(01):179.[doi:10.3969/j.issn.1006-1959.2019.01.058]
　XIONG Li,JIANG Ming-min,HE Ya-juan.Application Study of Nurse-led Pain Management Model in Perioperative Period of Cesarean Section[J].Medical Information,2019,32(11):179.[doi:10.3969/j.issn.1006-1959.2019.01.058]
[11]单会荣,涂莹莹.腰麻下罗哌卡因复合硬膜外不同剂量舒芬太尼用于剖宫产麻醉的临床效果观察[J].医学信息,2021,34(22):106.[doi:10.3969/j.issn.1006-1959.2021.22.032]
　SHAN Hui-rong,TU Ying-ying.Clinical Effect of Ropivacaine Combined with Different Doses of Sufentanil in Epidural Anesthesia for Cesarean Section Under Spinal Anesthesia[J].Medical Information,2021,34(11):106.[doi:10.3969/j.issn.1006-1959.2021.22.032]
[12]王 赢,李 辉.硬膜外麻醉与腰硬联合麻醉在剖宫产中的麻醉效果及对血流动力学的影响[J].医学信息,2024,37(17):77.[doi:10.3969/j.issn.1006-1959.2024.17.014]
　WANG Ying,LI Hui.Anesthetic Effect of Epidural Anesthesia and Combined Spinal Epidural Anesthesia in Cesarean Section and its Influence on Hemodynamics[J].Medical Information,2024,37(11):77.[doi:10.3969/j.issn.1006-1959.2024.17.014]

更新日期/Last Update: 1900-01-01