河北地区阴道分娩产后尿潴留的发病率及危险因素分析

Incidence rate and risk factors of postpartum urinary retention after vaginal delivery in parturient women in Hebei province

目的探讨河北地区多中心产妇阴道分娩产后尿潴留(PUR)的发病率及危险因素。方法选取2020年1月至2020年12月河北地区11家医院经阴道分娩的12793例产妇为研究对象,发生PUR的537例为观察组,剩余正常孕妇中随机选取530例为对照组,采用Logistic多因素回归分析阴道分娩产后尿潴留的危险因素。结果河北地区阴道分娩PUR的发病率为4.20%;观察组第一产程时间、第二产程时间均长于对照组,差异有统计学意义(t值分别为3.495、5.394,P<0.05);观察组总产程时间、新生儿体重及使用分娩镇痛、产钳助产、会阴侧切、缩宫素比例均高于对照组,差异有统计学意义(χ^(2)值分别为29.234、15.506、25.566、55.821、12.038、5.768,P<0.05);Logistic多因素回归结果表明产程时间≥12h、新生儿体重≥3.5kg、使用分娩镇痛、产钳助产、会阴侧切、缩宫素均为PUR发生的独立危险因素(OR值分别为5.336、3.968、3.245、2.028、3.386、1.987,P<0.05)。结论产程时间较长、新生儿体重较大、使用分娩镇痛、产钳助产、会阴侧切、缩宫素均会增加PUR的发生风险,采取适当的对应措施可干预PUR的发生。

Objective To investigate incidence rate and risk factors of postpartum urinary retention(PUR)after vaginal delivery in parturient women in multi-centers of Hebei province.Methods 12793 parturient women who underwent vaginal delivery in 11 hospitals in Hebei province from January to December,2020 were selected as study subjects.Of them,537 parturient women who had PUR were divided into observation group,and 530 normal parturient women who were selected randomly from all normal parturient women were divided into control group.Logistic multivariate regression was used to analyze risk factors of PUR after vaginal delivery.Results The incidence rate of PUR after vaginal delivery in Hebei province was 4.20%.The first stage of labor and the second stage of labor of the parturient women in the observation group were both longer than those in the control group,and the differences were statistically significant(t=3.495 and 5.394 respectively,both P<0.05).The duration of total stage of labor,newborn′s birth weight,and the proportions of the parturient women who received labor analgesia,delivered with forceps,underwent lateral perineotomy and were given oxytocin during their delivery in the observation group were all higher than those in the control group,and the differences were statistically significant(χ^(2)=29.234,15.506,25.566,55.821,12.038 and 5.768 respectively,all P<0.05).Logistic multivariate regression analysis showed that labor duration≥12 h,neborn′s birth weight≥3.5 kg,labor analgesia,delivery with forceps,lateral perineotomy,and administration of oxytocin were all independent risk factors for PUR(OR=5.336,3.968,3.245,2.028,3.386 and 1.987 respectively,all P<0.05).Conclusion Long labor duration,large newborn′birth weight,labor analgesia,labor assisted by forceps,lateral perineotomy and administration of oxytocin are independent risk factors for occurrence of PUR,and appropriate corresponding measures can be taken to reduce incidence rate of PUR.