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。
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.
作者
刘岩
刘永
LIU Yan;LIU Yong(Department of Anesthesiology,Tianjin Port Hospital,Tianjin 300456,China)
出处
《医学信息》
2020年第11期111-113,共3页
Journal of Medical Information
关键词
剖宫产
硬膜外麻醉
尿滞留
危险因素
防治措施
Cesarean section
Epidural anesthesia
Urine retention
Risk factors
Preventive measures
