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| Application of Comprehensive Intervention Based on Risk Nomogram Model in Patients with Urinary Retention after Vaginal Delivery |
| CHEN Li-qin, YIN Sheng-xian |
| Department of Obstetrics and Gynecology, Changshu Hospital of Traditional Chinese Medicine (New Area Hospital), Changshu Jiangsu 215500 |
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Abstract 【Objective】 To explore the value of comprehensive intervention based on risk nomogram model in patients with urinary retention after vaginal delivery. 【Methods】The clinical data of 856 cases of vaginal delivery in our hospital from January 2018 to March 2019 were retrospectively analyzed. According to whether urinary retention occurred or not,they were divided into urinary retention group (n=62) and normal group (n=794), logistics regression model was used to screen the risk factors of urinary retention after vaginal delivery. In a prospective study, 173 cases of vaginal delivery women who were diagnosed and treated in our hospital from May 2019 to October 2019 were randomly divided into observation group and control group. The observation group received comprehensive intervention based on risk line chart prediction model, while the control group received routine intervention. The time of self urination, incidence of urinary retention, postpartum hemorrhage of 2 h and residual urine volume of 6 h after delivery were compared between the two groups. 【Results】 A retrospective analysis showed that the incidence of postpartum urinary retention was 7.24% (62/856 ). Logistic regression analysis showed that labor analgesia, forceps delivery, hand to head transfer, first stage of labor and second stage of labor were independent risk factors for urinary retention after vaginal delivery (P< 0.05). According to the risk factors of urinary retention after vaginal delivery, a nomogram prediction model was constructed. The ROC curve was used to evaluate the nomogram of the nomogram , the area under the ROC curve was 0.790, the slope of the calibration curve was close to 1, and the discrimination and accuracy were good. In the prospective study, the time of self urination in the observation group was shorter than that in the control group, and the incidence of urinary retention was lower than that in the control group (P< 0.05). The amount of postpartum hemorrhage at 2 hours and residual urine at 6 hours in the observation group were less than those in the control group (P<0.05). 【Conclusion】 Comprehensive intervention based on risk nomogram prediction model can help prevent urinary retention after vaginal delivery, reduce postpartum hemorrhage and residual urine volume, and is worthy of clinical application.
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Received: 07 December 2021
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[1] 杨彩霞, 唐淑稳, 兰淑海,等. 阴道分娩97例初产妇产后尿潴留危险因素临床分析[J].国际妇产科学杂志, 2018, 45(6):700-703.
[2] 邱海凡, 王连云, 潘圆圆,等. 剖宫产术后瘢痕子宫阴道分娩的可行性和安全性研究[J].中华全科医师杂志, 2019, 18(5):458-461.
[3] 古慧贤. 阴道分娩后急性尿潴留的影响因素及护理[J].国际护理学杂志, 2016, 35(18):2449-2452.
[4] TIBERON A, CARBONNEL M, VIDART A, et al. Risk factors and management of persistent postpartum urinary retention[J].J Gynecol Obstet Hum Reprod,2018,47(9):437-441.
[5] 郭学齐,闫贵贞,张彩霞,等.决策树模型与Logistic回归模型在产后尿潴留发生影响因素分析中的作用[J].中国医药导报,2019,16(26):85-88.
[6] 欧有良. 产后尿潴留导尿时不同排放尿量对产后正常排尿功能重建的影响[J].实用妇产科杂志, 2017, 33(4):311-313.
[7] 周素芬,黄爱武,蒋啸波.阴道分娩后尿潴留发生的相关危险因素分析[J].现代实用医学,2018,30(8):1070-1072.
[8] 付芬芬.产后尿潴留病人中西医预防及护理研究进展[J].护理研究,2017,31(31):3917-3919.
[9] 殷素华.阴道分娩后尿潴留的相关因素分析及盆底康复干预的效果研究[J].中国妇幼保健,2017,32(10):2093-2095.
[10] 李超, 李渊, 李芷茹,等. 早期盆底肌肉训练及电刺激治疗对产后盆底康复影响的研究[J].中国康复, 2019, 34(1):22-25.
[11] 董金填, 李群杰, 姚伟瑜. 瑞芬太尼静脉分娩镇痛的研究进展[J].临床麻醉学杂志, 2019, 35(6):607-610.
[12] 冯佩笑, 陈成杯, 杨文懿, 等. 产钳助产术后尿潴留发生情况及其影响因素分析[J].现代临床护理, 2017, 16(11):1-4.
[13] 孙芳璨, 吴芳芳, 沈敏红, 等. 足月妊娠低风险初产妇阴道试产失败中转剖宫产预测模型的建立[J].中华围产医学杂志, 2020, 23(7):460-468. |
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2022, Vol. 39 
