產後排尿功能障礙及尿液滯留

Postpartum Voiding Dysfunction and Urinary Retention

10.6518/TJOM.201812_(60).0001

林素瑛(Su-Ying LIN)；高美玲(Meei-Ling GAU)

產後 ； 尿液滯留 ； 排尿困難

助產雜誌

60期（2018 / 12 / 01）

1 - 11

繁體中文

排尿困難（postpartum voiding dysfunction）和尿液滯留（postpartum urinary retention）是產後初期常見的現象，在台灣產後尿液滯留的發生機率為7.78%，顯示發生機率極高，當無法及時發現和治療尿液滯留的問題時，會因為膀胱過度膨脹，影響子宮收縮，宮縮不良會導致產後早期大出血，並且會因為尿液鬱積，而顯著減少排尿時逼尿肌的收縮能力，會導致逼尿肌永久性的損傷，腎臟功能受損和罕見的膀胱破裂。因此，在照顧尿液滯留的產婦時，當護理助產人員具有膀胱照護相關專業知識時，就能夠及時診斷出尿液滯留的護理問題，並立即給予產婦治療，就能夠預防膀胱損傷，以及長期的後遺症發生。此篇文章主旨在於回顧產後尿液滯留的相關文獻，如：發生機率、病理因素、產科相關的危險因子、臨床表現、以及相關處置等，供產科相關醫護人員參考。

1. Carley, M. E.,Carley, J. M.,Vasdev, G.,Lesnick, T. G.,Webb, M. J.,Ramin, K. D.,Lee, R. A.(2002).Factors that are associated with clinically overt postpartum urinary retention after vaginal delivery.American Journal of Obstetrics Gynecology,187(2),430-433.
2. Cavkytar, S.,Kokanali, M. K.,Baylas, A.,Topcu, H. O.,Laleli, B.,Tasci, Y.(2014).Postpartum urinary retention after vaginal delivery: Assessment of risk factors in a case-control study.Journal of the Turkish-German Gynecological Association,15(3),140-143.
3. Chung, L. C.,Dhy, C. S.,Hong, T. L.,Chang, H. C.,Lun, C. C.,Jen, C. P.(2002).Postpartum urinary retention: Assessment of contributing factors and long-term clinical impact.The Australian and New Zealand Journal of Obstetrics and Gynaecology,42(4),365-368.
4. Demaria, F.,Boquet, B.,Porcher, R.,Rosenblatt, J.,Pedretti, P.,Raibaut, P.,Benifla, J. L.(2008).Post-voiding residual volume in 154 primiparae 3 days after vaginal delivery under epidural anesthesia.European Journal of Obstetrics & Gynecology and Reproductive Biology,138(1),110-113.
5. Duenas-Garcia, O. F.,Rico, H.,Gorbea-Sanchez, V.,Herrerias-Canedo, T.(2008).Bladder rupture caused by postpartum urinary retention.Obstetrics and Gynecology,112(2),481-482.
6. Groutz, A.,Gordon, D.,Wolman, I.,Jaffa, A.,Kupferminc, M. J.,Lessing, J. B.(2001).Persistent postpartum urinary retention in contemporary obstetric practice: Definition, prevalence and clinical implications.The Journal of Reproductive Medicine,46(1),44-48.
7. Jeanette, L. L.(2010).Post-partum voiding dysfunction and urinary retention.Australian and New Zealand Journal of Obstetrics and Gynaecology,50(6),502-505.
8. Kekre, A. N.,Vijayanand, S.,Dasgupta, R.,Kekre, N.(2011).Postpartum urinary retention after vaginal delivery.International Journal Gynaecology & Obstetrics,112(2),112-115.
9. Lin, Y. W., Tzeng, Y. L., & Pei, S. N. (2014). Postpartum urinary retention and contributing factors in Taiwanese women. Retrieved from http://www.nursinglibrary.org/vhl/bitstream/10755/335353/1/Lin,+Ya-Wen+-Postpartum+Urinary+Retention.pdf
10. Midwifery Educator-Physiotherapist and Urogynaecologist. (2017). Bladder care postpartum and management of urinary retention. Retrieved from http://Bladder-Care-Postpartum_2017-11-20.docx
11. Mulder, F. E. M. (2017). Postpartum urinary retention: Risk factors, clinical impact and management. Retrieved from of http://ure.uva.nl/ws/files/19918770/Thesis.pdf
12. Mulder, F. E. M.,Rengerink, K. O.,Post, J. A. N.,Hakvoort, R. A.,Roovers, J. P.(2016).Delivery-related risk factors for covert postpartum urinary retention after vaginal delivery.International Urogynecology Journal,27(1),55-60.
13. Mulder, F. E. M.,Schoffelmeer, M. A.,Hakvoort, R. A.,Limpens, J.,Mol, B.W.,van der Post, J. A.,Roovers, J. P.(2012).Risk factors for postpartum urinary retention: A systematic review and meta-analysis.An International Journal of Obstetrics and Gynaecology,119(12),1440-1446.
14. Mulder, F. E. M.,Van der Velde, S.,Pol, F. J. M.,Bos, M.,Van Leeuwen, J. H. S.,Dietz, V.,Roovers, J. P. W. R.(2018).The accuracy of post void residual volumes after vaginal delivery: A prospective equivalence study to compare an automatic scanning device with transurethral catheterization.International Urogynecology Journal
15. Mustonen, S.,Ala-Houhala, I. O.,Tammela, T. L.(2001).Long-term renal dysfunction in patients with acute urinary retention.Scandinavian Journal of Urology and Nephrology,35(1),44-48.
16. Obstetrics and Gynaecology News-Incorporating Women's Health. (2011). Post-partum bladder care: Background, practice and complications. Retrieved from http://www.ogpnews.com/2011/12/post-partum-bladder-care-background-practice-and-complication/444
17. Ramsay, I. N.,Torbet, T. E.(1993).Incidence of abnormal voiding parameters in the immediate postpartum period.Neurourology and Urodynamics,12(2),179-183.
18. Weiniger, C. F.,Wand, S.,Nadjari, M.,Elchalal, U.,Mankuta, D.,Ginosar, Y.,Matot, I.(2006).Post-void residual volume in labor: A prospective study comparing parturients with and without epidural analgesia.Acta Anaesthesiologica Scandinavica,50(10),1297-1303.
19. Yip, S. K.,Brieger, G.,Hin, L. Y.,Chung, T.(1997).Urinary retention in the post-partum period. The relationship between obstetric factors and the post-partum post-void residual bladder volume.Acta Obstetricia Gynecologica Scandinavica,76(7),667-672.
20. 余玉眉校閱(2016)。產科護理學。台北:新文京。
21. 李耀泰、郭宗正、陳福民(2006)。產後小便滯留。當代醫學，33(3)，206-209。
22. 高美玲校閱(2017)。實用產科護理。台北:華杏。
23. 曹麗英校閱(2013)。基本護理學。台北:新文京。
24. 梁景忠校閱(2013)。當代婦女泌尿暨骨盆醫學。台北:合記。
25. 樓迎統校閱(1998)。實用生理學。台北:匯華。