穴位敷贴联合按揉法对产后尿潴留膀胱功能的影响及临床效果观察

Effect of Acupressure Combined with Kneading Method in Treatment of Bladder Function of Postpartum Patients with Urinary Retention

目的：探讨产后尿潴留患者在应用穴位敷贴和按揉法治疗后对其膀胱功能的影响及疗效的研究,为临床提供有效的治疗方案。方法：产后尿潴留患者83例随机分为对照组41例和观察组42例,分别采用不同的治疗方式,其中对照组患者采取常规开塞露纳肛法,观察组患者在对照组的基础上加用穴位服帖联合按揉法治疗,观察两组患者在治疗后8 h内的首次排尿情况,采用Nidoc-970A尿动力学仪检查患者的膀胱初感容积、最大膀胱容量、最大尿流率、最大尿流率时逼尿肌压力,同时统计患者治疗后的有效率及不良反应发生情况。结果：（1）两组患者在治疗后尿潴留情况均得到改善,其中观察组患者首次4h内排尿18例,4～6 h排尿22例,6～8 h排尿2例,明显优于对照组患者（P均〈0.05）;（2）观察组患者的膀胱初感容积（135.56±29.24）m L、最大膀胱容量（365.69±55.42）m L、最大尿流率（17.05±5.39）m L/s、最大尿流率时逼尿肌压力（37.16±4.26）cm H2O明显高于对照组（P均〈0.05）;（3）观察组患者的治疗有效率为97.62%明显高于对照组的82.93%,而对照组患者出现不良反应发生率明显高于观察组（P均〈0.05）。结论：产后尿潴留患者应用穴位敷贴与按揉法联合治疗,能够有效改善患者的膀胱功能,促进患者尽早自主排尿,具有高效的临床治疗率。

Objective： To explore the clinical effect of acupressure combined with kneading method in the treatment of bladder function of postpartum patients with urinary retention so as to provide effective clinical treatment. Methods： Eighty-three patients with postpartum urinary retention were randomly divided into the control group（ n = 41） and the observation group（ n = 42）. They were given different treatment methods. The patients in the control group were treated with conventional open sorean anal method,and the patients in the observation group were treated with acupressure combined with kneading method. The first urination in the two groups was observed within 8 hours after treatment. Nidoc-970 A urodynamic instrument was used to check the bladder initial volume,maximum bladder capacity,maximum urinary flow rate and maximal urinary flow rate detrusor pressure. The effectiveness of patients after treatment and the incidence of adverse reactions of the two groups at the same time were taken for statistics. Results：（1）The urinary retention in the two groups was improved after treatment. The patients in the observation group had 18 cases of urination for the first time,22 cases were urinated at 4-6 h,2 cases were urinated at 6-8 h,and the patients were better than those of the control group（ P〈 0. 05）.（2）The total bladder volume（ 135. 56 ± 29. 24） m L,the maximum bladder capacity（ 365. 69 ± 55. 42） m L,the maximum urinary flow rate（ 17. 05 ± 5. 39） m L/s,the maximal urinary flow rate detrusor pressure（ 37. 16 ± 4. 26） cm H2 O in the observation group were significantly higher than those of the control group（ P 〈0. 05）.（3）The effective rate of treatment of the observation group（ 97. 62%） was significantly higher than that in the control group（ 82. 93%）,while the incidence of adverse reactions in the control group was significantly higher than that in the observation group（ P 〈0. 05）.Conclusion： The combination of acupressure combined with kneading method can improve the bladder function of the pa-tients and promote the spontaneous urination of the patients as soon as possible,and has effective clinical treatment rate.