阴道分娩后尿潴留相关因素分析

目的:通过产后尿潴留发病因素的分析,探讨预防措施,以期降低产后尿潴留的发生率。方法:回顾性分析我院2009年10月至2010年9月间阴道分娩者产后尿潴留的发病因素,包括产妇年龄、助产、并发症、分娩镇痛、Ⅰ+Ⅱ产程时限以及初次排尿时间。结果:阴道分娩的5 696例产妇中,85例发生尿潴留,发生率为1.49%。Ⅰ+Ⅱ产程≥12 h、器械助产、接受宫颈封闭、缩宫素静脉滴注的产妇尿潴留发生率显著高于对照组,合并糖耐量异常产妇尿潴留发生率较高,初次排尿时间≥6 h的产妇产后尿潴留发生率升高;分娩镇痛及年龄≥35岁产妇尿潴留发生率与对照组差异无统计学意义。结论:Ⅰ+Ⅱ产程≥12 h、器械助产、宫颈封闭、缩宫素静脉点滴、糖代谢异常、产后初次排尿时间>6 h均是产后尿潴留的高风险因素。

Analysis on etiological factors of postpartum urinary retention after vaginal delivery

Objective: To determine obstetric variables contributing to postpartum urinary retention(PUR).Methods: Women who suffered PUR after vaginal delivery during October 2009 to September 2010 in Beijing Obstetrics and Gynecology Hospital were retrospectively studied by analyzing their age,delivery mode,obstetric complication,epidural anesthesia,duration of labor(Ⅰ+Ⅱ),the period of first urination after labor between women with or without PUR.Results: 5 696 participants were recruited in the study and 1.49 percent(85 cases) of them suffered with PUR.Women with instrument-assisted delivery were more likely to suffer PUR than those without(5.98% vs 1.18%,P<0.01),and so did women with abnormal glucose metabolism(3.66% vs 1.03%,P<0.01),induction of labor by oxytocin(2.68% vs 1.04%,P<0.01),cervix blockade(2.98% vs 1.03%,P<0.01) and duration of labor(Ⅰ+Ⅱ) more than 12 hours(2.3% vs 1.2%,P=0.006).There was a close correlation between first urination 6 hours or more after labor and incidence PUR.No association was found with epidural anesthesia or age between women with or without PUR.Conclusion: Prolonged labor(Ⅰ+Ⅱ),instrument-assisted delivery,cervix blockade in labor,induction of labor by oxytocin,abnormal glucose metabolism,the period of first urination after labor more than 6 hours are the risk factors of PUR.