中药封包外敷与穴位按压法对神经学相关尿潴留高危因素产妇膀胱功能恢复的研究

Study on bladder function recovery of pregnant women with high risk factors of neurologicallyrelated urinary retention by external application of Chinese medicine and acupressure

目的:探讨中药封包与穴位按摩对具有神经学相关尿潴留高危因素产妇产后膀胱排尿功能恢复的临床效果。方法:选取阴道分娩中具有神经学相关尿潴留高危因素的单胎初产妇100例,随机分为研究组和对照组,各50例。选取同期无任何产后尿潴留高危因素的50例正常单胎分娩初产妇作为正常组。各组产妇产后均实施常规处理,研究组采取中药封包与关元穴位按摩联合疗法。统计产妇产后自行排尿、诱导性排尿及尿潴留的发生率。对自行排尿者记录产后首次排尿的间隔时间、排尿总量、膀胱残余的尿量等。结果:各组产妇在产后排尿方式间均存在统计学差异(P<0.05),主要表现为自行排尿与尿潴留发生率之间(均P<0.05),而诱导性排尿率之间差异不明显(P>0.05)。两两比较分析,对照组产后自行排尿和尿潴留的发生率与研究组及正常组相比,差异均有统计学意义(均P<0.05),而研究组与正常组之间无统计学差异(均P>0.05)。各组产妇在产后首次排尿的间隔时间、膀胱残余的尿量、平均的尿流率、排尿积分及排尿持续时间之间存在统计学差异(均P<0.05)。而在产后首次排尿总量方面则无统计学差异(P>0.05),进一步两两比较分析表明,对照组在首次排尿的间隔时间、膀胱残余的尿量、平均的尿流率、排尿积分、排尿持续时间要分别差于研究组及正常组(均P<0.05),而研究组与正常组之间则无统计学差异(P>0.05)。结论:中药封包外敷与穴位按压的联合方案可有效促进具有神经学相关尿潴留高危因素产妇产后膀胱排尿功能的恢复,降低产妇产后尿潴留的发生率。

Objective:To explore the clinical effect of traditional Chinese medicine packaging combined with acupoint massage on the recovery of bladder voiding function in parturient women with high risk factors of neurological postpartum urinary retention.Methods:A total of 100 singleton primiparas with neurological-related urinary retention high-risk factors who were delivered vaginally were selected and randomLy divided into study group and control group,with 50 cases in each group.50 cases of normal delivery primiparas without high risk factors for postpartum urinary retention during the same period were selected as the normal group.Both groups of parturient women were routinely treated after delivery,and the study group took Guan Yuan acupoint massage and Chinese medicine package therapy.The cases of spontaneous urination,induced urination and retention of urine were observed in the two groups of parturient women.The interval time between the first urination,the volume of urination,the residual urine of the bladder and other indicators were recorded for spontaneous urination parturient women.Results:There were statistically significant differences in postpartum urination patterns among the three groups of women(P<0.05),mainly manifested as between spontaneous urination and urinary retention(all P<0.05),but there was no significant difference in induced urination(P>0.05).Pairwise comparative analysis,the incidence of spontaneous urination and urinary retention in the control group compared with the study group and the normal group,the difference was statistically significant(all P<0.05),but there was no statistical difference between the study group and the normal group(P>0.05).There were statistical differences in the time interval of first urination,bladder residual urine volume,average urinary flow rate,urination score and urination duration between the three groups of women(all P<0.05).However,there was no statistical difference in the first postpartum voiding volume(P>0.05).Further pairwise comparison analysis showed that the control group had the first voiding interval,bladder residual urine volume,average urine flow rate,voiding score,and voiding duration.The indicators were worse than the study group and the normal group(all P < 0.05),but there was no statistical difference between the study group and the normal group( P > 0.05).Conclusions:The combination of traditional Chinese medicine package and acupoint massage can effectively promote the recovery of postpartum bladder voiding function of the high-risk factors of neurological postpartum urinary retention and reduce the occurrence of postpartum urinary retention.