留置导尿加膀胱冲洗治疗顽固性产后尿潴留100例

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尿潴留是产妇产后常见的合并症,也是造(?)产后子宫恢复不良,泌尿系感染的重要因素之一。本文就留置导尿加膀胱冲洗治疗顽固性产后尿潴留100例。作如下分析.1 一般资料近两年来,100例中产后8—24h未排尿者81例,产后24—72h未排尿者15例,产后72—96h未排尿者4例.2 方法给予留置导尿,定时开放尿液引(?)管,每日两次用0.9%氧化钢溶液250ml加入硫酸庆大霉素8万单位膀胱冲洗,3h后拔除尿管,即可自行排尿.注意膀胱冲洗首应放出尿液,注入药液后应保留10—15min放出;尿液引流管每4h开放一次,引流管及尿袋每日更换一次,同时应保持会阴部清洁。如膀胱过度膨胀,第一次导尿量不超过1000ml,以免引起产妇虚脱或膀胱内压骤减而致膀胱粘膜出血.3 讨论造成产后尿潴留的原因为:临产及贻先露部分长期压迫产妇盆底神经,造成神经麻痹,影响其传导功能,分娩中第二产程延长使胎先露严重压迫子宫的前膀胱壁,使其水肿而膀胱壁感受器迟钝,产伤或会阴部切口局部疼痛等.留量导尿,待3日后,上述外因消失后,拔除尿管,即可自行排尿,故上述方法对顽固性产后尿潴留具有良好疗效。 Urinary retention is a common complication of postpartum mothers, but also create (?) Postpartum uterine failure, urinary tract infection, one of the important factors. This article indwelling catheterization plus bladder irrigation treatment of refractory postpartum urinary retention in 100 cases. For the following analysis.1 General information In the past two years, 100 cases of 8-24h postpartum non-voiding in 81 cases, postpartum 24-72h 15 cases without voiding, 72-96h postpartum non-voiding in 4 cases .2 method for indwelling catheterization , Regularly open the urine lead (?) Tube, twice daily with 0.9% oxidized steel solution 250ml added gentamicin sulfate bladder 80,000 units, 3h after removal of the catheter, you can urinate. Note that the first bladder irrigation should Release the urine, infusion should be retained after 10-15min release; urine drainage tube open once every 4h, drainage tube and urine bag daily replacement, and should keep the perineum clean. Such as excessive bladder expansion, the first catheter volume does not exceed 1000ml, so as not to cause maternal collapse or sudden decrease in bladder pressure caused by bladder mucosal hemorrhage .3 Discussion Postpartum urinary retention due to the reasons: labor and Yi Xian Xian part of the long-term oppression of mothers Pelvic nerve, resulting in nerve paralysis, affecting its conduction function, prolonged delivery in the second stage of labor so that the fetus serious oppression of the uterus before the bladder wall, so that edema and bladder wall receptors dull, birth trauma or perineal incision local pain and so on. Stay catheterization, after 3 days, the disappearance of the external causes, removal of the catheter, you can urinate, so the above method of refractory postpartum urinary retention has a good effect.
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