【摘要】 目的探讨剖宫产产妇术后尿路感染的危险因素及盆底功能训练对预防尿潴留的效果,为临床防治提供参考依据。方法选取成都医学院第一附属医院2015年11月-2017年12月收治的2 386例剖宫产产妇作为研究对象,将其就诊编号按随机分层法分为观察组1 367例与对照组1 019例,对照组按常规剖宫产后临床路径进行干预,观察组则进行盆底功能训练,先以回顾性分析方式采集其临床资料,应用Logistic回归分析剖宫产产妇术后尿路感染的危险因素,并统计两组尿潴留发生率。结果以剖宫产后有无发生尿路感染作为应变量,以单因素Logistic分析有统计学意义选项为自变量,行Logistic分析可见低血红蛋白、合并糖尿病及高血压等基础疾病、插管次数(导尿管)≥2次、导尿管留置时长≥2 d、抗菌药物连用均为剖宫产产妇术后尿路感染的危险因素;且给予盆底功能训练的观察组尿潴留发生率(5.85%)显著低于对照组(14.92%),对比差异有统计学意义(P<0.05)。结论低血红蛋白、合并基础疾病、插管次数≥2次、导尿管留置时长≥2 d、抗菌药物连用均为剖宫产产妇术后尿路感染的危险因素,临床应予以重视,并积极给予盆底功能训练,以减少尿潴留发生。更多还原

【Abstract】 Objective To explore the risk factors of urinary tract infection after cesarean section and the preventive effect of pelvic floor function training on urinary retention,provide a reference basis for clinical prevention and treatment. Methods From November 2015 to December 2017,2 386 women after cesarean section were selected from the First Affiliated Hospital of Chengdu Medical College as study object. All the cases were divided into observation group( 1 367 cases) and control group( 1 019 cases) according to stratified random sampling method. The cases in control group were treated by routine clinical pathway after cesarean section,and the cases in observation group were treated by pelvic floor function training. The clinical data was collected by retrospective analysis. Logistic regression analysis was used to analyze the risk factors of urinary tract infection after cesarean section. the incidence rates of urinary retention in the two groups were statistically analyzed. Results With the presence of urinary tract infection after cesarean section as the dependent variable and the items with statistical significance as independent variables,logistic analysis showed that low hemoglobin,complicated with basic diseases( diabetes and hypertension),intubation for two times or more than two times,long catheter indwelling time( equal to or more than two days),and continuous use of antibiotics were risk factors of urinary tract infection after cesarean section. The incidence rate of urinary retention in observation group was 5. 85%,which was statistically significantly lower than that in control group( 14. 92%)( P<0. 05). Conclusion Low hemoglobin,complicated with basic diseases,intubation for two times or more than two times,long catheter indwelling time( equal to or more than two days),and continuous use of antibiotics are risk factors of urinary tract infection after cesarean section,more attention should be paid to,active pelvic floor function training can reduce the incidence rate of urinary retention.更多还原