硬脊膜外镇痛阴道分娩产妇产后尿潴留的危险因素分析
楼梦晓 1方旦 1戴旭萍 1程默1
作者信息
摘要
目的 探讨硬脊膜外镇痛阴道分娩产妇产后尿潴留(PUR)发生情况及影响因素.方法 回顾性分析436例硬脊膜外镇痛阴道分娩产妇的临床资料,根据是否发生PUR分为PUR组(31例)和未发生PUR组(405例),采用单因素和多因素Logistic回归分析硬脊膜外镇痛阴道分娩产妇PUR发生的相关危险因素.结果 硬脊膜外镇痛阴道分娩产妇PUR发生率为7.11%.单因素分析结果第一产程时间、第二产程时间、硬脊膜外镇痛时间、产次、产钳助产、催产素的使用、会阴裂伤和间歇导尿次数与PUR的发生存在相关性(P<0.05).Logistic回归分析显示:产次/初产妇(OR=7.052)、会阴Ⅱ度及以上程度裂伤(OR=5.907)、产钳助产(OR=5.016)、使用催产素(OR=3.020)、镇痛时间(OR=1.164)是硬脊膜外镇痛阴道分娩产妇PUR的危险因素.间歇导尿次数(OR=0.355)是硬脊膜外镇痛阴道分娩产妇PUR的保护因素.结论 对于硬脊膜外镇痛阴道分娩产妇,应严格合理控制产程中硬脊膜外镇痛给药时间及麻醉药物剂量,严格控制产钳助产指征,减少会阴损伤,以降低PUR的发生.
Abstract
Objective To investigate the incidence and influencing factors of postpartum urinary retention in women with vaginal delivery and epidural analgesia.Methods The medical records of 436 pregnant women with epidural analgesia vaginal delivery were retrospectively selected.They were divided into the post-production PUR group(31)and non-PUR group(405).The risk factors of postpartum urinary retention of pregnant women with epidural analgesia vaginal delivery were analyzed by single factor and binary logistic regression.Results The incidence of postpartum urinary retention in women with vaginal delivery after epidural analgesia was 7.11%(31/436).Univariate analysis showed that the duration of the first stage of labor,the second stage of labor,the duration of epidural analgesia,the number of births,forceps delivery,the use of oxytocin,perineal laceration,and the number of intermittent catheterizations were associated with the occurrence of postpartum urinary retention(P<0.05).Logistic regression analysis showed that the delivery times/primipara(OR=7.052),the second-degree perineal laceration(OR=5.907),the clamp midwifery(OR=5.016),the oxytocin use(OR=3.020),and the duration of analgesia(OR=1.164)were risk factors for postpartum urinary retention in women with vaginal delivery after epidural analgesia.The number of intermittent catheterization(OR=0.355)was a protective factor for postpartum urinary retention in women with epidural analgesia vaginal delivery.Conclusion For epidural analgesia and vaginal delivery,the epidural analgesia administration time and anesthetic dose should be strictly and reasonably controlled,and the indications of forceps should be strictly controlled to reduce perineal damage,so as to reduce the occurrence of postpartum urinary retention.
关键词
阴道分娩/硬脊膜外镇痛/产后尿潴留/影响因素Key words
Vaginal delivery/Epidural analgesia/Postpartum urinary retention/Influence factor引用本文复制引用
出版年
2024
NETL
NSTL
万方数据