产后尿潴留发病危险因素Meta分析

doi:10.16460/j.issn1008-9969.2020.20.001

摘要/Abstract

摘要： 目的通过Meta分析明确产妇发生尿潴留的危险因素,为其防治提供科学依据。方法计算机检索中国知网、维普、中国生物医学文献数据库（CBM）、万方、PubMed、Embase、EBSCO、Web of Science、Cochrane Library,收集关于产妇产后并发尿潴留危险因素的病例对照研究或队列研究,检索时限为自建库至2019年6月。研究者按照标准进行文献筛选、资料提取和质量评价,采用RevMan 5.3软件进行定量综合Meta分析。结果最终纳入14篇文献,累计病例组产妇1 818例,对照组人群5 194例,共10项危险因素。Meta分析结果显示,产钳助产（OR=5.40,95%CI:4.48~6.52）、手转胎头（OR=5.12,95%CI:3.05~8.60）、存在不良情绪（OR=4.84,95%CI:3.84~6.10）、会阴撕裂伤（OR=2.80,95%CI:1.25~4.24）、会阴切开术（OR=1.95,95%CI:1.23~3.09）、产程延长（OR=1.68,95%CI:1.59~1.77）、分娩镇痛（OR=1.48,95%CI:1.32~2.45）是产后尿潴留的危险因素,而胎头吸引（OR=2.95,95%CI:0.85~10.23）、初产妇（OR=1.33,95%CI:0.96~1.83）、产前排空膀胱（OR=1.10,95%CI:0.28~4.28）与产后尿潴留发病无关。敏感性分析与发表偏倚结果显示各因素合并结果较稳定,发表偏倚不明显。结论产后尿潴留的发生与多种暴露因素有关,其危险强度由高到低依次为产钳助产、手转胎头、存在不良情绪、会阴撕裂伤、会阴切开术、产程延长、分娩镇痛。

关键词: 产后尿潴留, 危险因素, Meta分析

Abstract: Objective To explore the main factors related to the incidence of postpartum urinary retention(PUR) by meta analysis and to provide evidence for PUR prevention and control. Methods We retrieved China National Knowledge Infrastructure(CNKI), Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Data- base (CBM), Wanfang Database, PubMed, Embase, BSCO, Web of Science, and Cochrane Library from the inception to June 2019 to collect studies on factors related to the incidence of PUR. A meta-analysis on the included literatures was performed by using RevMan 5.3. Results Totally 14 articles were included,involving 1,818 cases and 5,194 controls. Meta-analysis showed that risk factors of PUR were forceps delivery (OR=5.40,95%CI:4.48~6.52),manual rotation of fetal head (OR=5.12,95%CI:3.05~8.60), maternal presence of adverse emotions (OR=4.84,95%CI:3.84~6.10), laceration of perineum (OR=2.80,95%CI:1.25~4.24),episiotomy(OR=1.95,95%CI:1.23~3.09),prolonged labor (OR=1.68,95%CI:1.59~1.77), and peridural anesthesia (OR=1.48,95%CI:1.32~2.45),. There was no correlation with vacuum extractor of fetal head (OR=2.95,95%CI:0.85~10.23), primiparous (OR=1.33,95%CI:0.96~1.83), prepartum bladder catheterization (OR=1.10,95%CI:0.28~4.28). Sensitivity analysis and publication bias test indicated that there was no publication bias for case-control studies and the results of the meta-analysis were stable. Conclusion The occurrence of PUR are related to various risk factors, and factors with risk intensity ranging from high to low are forceps, hand rotation of fetal head, maternal adverse emotions, laceration of perineum, episiotomy, prolonged labor process, and labor analgesia.

Key words: postpartum urinary retention, risk factor, Meta-analysis

中图分类号:

R473.71

庞艳, 林芳初, 李嫒, 宁佳惠, 周荣, 涂素华. 产后尿潴留发病危险因素Meta分析[J]. 护理学报, 2020, 27(20): 1-6.

PANG Yan, LIN Fang-chu, LI Ai, Ning Jia-hui, ZHOU Rong, TU Su-hua. Meta-analysis of Risk Factors for Postpartum Urinary Retention[J]. Journal of Nursing, 2020, 27(20): 1-6.

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