穴位注射联合艾灸对阴道助产产后尿潴留的疗效观察及护理

何海燕等

[摘要] 目的 穴位注射联合艾灸治疗阴道助产产后尿潴留的效果观察及护理体会。 方法 将60例阴道助产产后尿潴留产妇随机分为两组，对照组采用常规护理及新斯的明穴位注射治疗，实验组增加艾灸干预措施，比较两组总有效率、自主排尿恢复时间及膀胱残余尿量。 结果 实验组总有效率高于对照组（93.3%VS73.3%，P<0.05）。实验组的自主排尿恢复时间（15.3±5.9）min，少于对照组（18.5±6.1）min，具有统计学意义（P<0.05）。实验组膀胱残余尿量也低于对照组（12.1±2.9）mL VS（13.8±3.4）mL，差异具有统计学意义（P<0.05）。 结论 新斯的明穴位注射联合艾灸治疗可有效改善阴道助产产后尿潴留。

[关键词] 穴位注射；艾灸；产后尿潴留

[中图分类号] R246.3 [文献标识码] B [文章编号] 2095-0616（2015）11-45-03

[Abstract] Objective To observe the effect of acupoint injection combined with moxibustion for postnatal urinary retention with Vaginal delivery. Methods 60 lying-in women with postnatal urinary retention were divided randomly into observation group（n=30） and control group（n=30）.Both groups were given conventional usual care，and additionally，the observation group received neostigmine acupoint injection combined with moxibustion，while the control group received neostigmine acupoint injection.The total effective rate，urinary recovery time and residual urine were observed. Results The total effective rate was higher significantly in the observation group than in the control group（P<0.05）.The urinary recovery time and residual urine were significantly shorter in the observation group than in the control group（P<0.05）. Conclusion Conclusion can be reached that neostigmine acupoint injection combined with moxibustion has the function on postnatal urinary retention with vaginal delivery.

[Key words] Acupoint injection；Moxibustion；Postnatal urinary retention

产后尿潴留是产科较为常见的产后并发症，是指产妇分娩后6～8h膀胱有尿液充盈但不能自行排出。导致产后尿潴留的因素很多[1-2]：有手术麻醉引起排尿中枢障碍或抑制；产程中[3]胎儿压迫膀胱，膀胱肌肉收缩发生障碍，对膀胱内压力增加欠敏感；产后盆腔内压力突然下降，引起盆腔内瘀血；产程过长引起体力的大量消耗，而导致排尿困难。临床上又以产程延长、阴道助产、产后疼痛、药物因素等为多见。尤其是对于阴道助产产妇，阴道手术助产使膀胱位置下垂，损伤子宫骶骨韧带两侧副交感神经，致使逼尿肌和膀胱括约肌功能失调。此外，环境因素、心理因素等也会造成产后尿潴留[4]：陌生的病房环境及不习惯卧床排尿等；会阴部创伤引起的疼痛导致产妇精神紧张恐惧而不敢排尿等。据文献报道产后尿潴留在顺产妇中的发生率约为10%～15%；阴道助产的产妇更易发生产后尿潴留，其发生率可达25%～30%[5]。如果尿潴留量较大、时间过长将会导致产妇不适、产妇子宫收缩不良，引发产后出血，不仅给产妇带来精神上的痛苦，还常引起膀胱炎[6]。……