足月妊娠引产时应用宫颈Cook球囊联合缩宫素的有效性和安全性

摘要/Abstract

摘要： 目的:观察足月妊娠引产时应用宫颈Cook球囊联合缩宫素的有效性和安全性。方法：选取2019年1月至2020年3月我院收治的84例足月妊娠引产产妇作为研究对象，按照随机数字表法分为对照组和观察组，每组各42例。对照组仅给予缩宫素引产；观察组给予宫颈Cook球囊联合缩宫素引产，比较两组产妇的促宫颈成熟效果、引产有效率、产程时长、经阴道分娩率、应激反应相关指标、母婴不良结局发生率。结果：引产后，观察组产妇的宫颈改良Bishop评分高于对照组(P<0.05)。观察组的促宫颈成熟有效率100%，高于对照组（85.71%）（P＜0.05）。与对照组相比，观察组诱发阴道分娩的产妇产程中潜伏期、活跃期、第二产程、总产程时长均缩短(P<0.05)。观察组的引产有效率为97.62%，优于对照组的80.95%（P＜0.05）。观察组产妇经阴道分娩率为92.86%，高于对照组产妇的76.19%（P＜0.05）。观察组产妇分娩后的应激反应指标血清儿茶酚胺(CA)、皮质醇(Cor)水平均低于对照组（P＜0.05）。观察组母婴不良结局发生率为7.14%，低于对照组的28.57%（P＜0.05）。两组均未见患儿出现死亡及败血症。结论：足月妊娠引产时应用宫颈Cook球囊联合缩宫素效果确切，更利于缩短产程，提升引产成功率、自然分娩率，降低分娩应激反应，母婴不良结局发生率低，安全性高。

关键词: font-size:medium, ">足月妊娠引产；宫颈Cook球囊；缩宫素；有效性；安全性

Abstract: Objective:To investigate the efficacy and safety of Cook cervical ripening balloon combined with oxytocin in term pregnancy induced labor. Methods: A total of 84 cases of term pregnancy induced labor treated in our hospital from January 2019 to March 2020 were divided into the control group and the observation group with 42 cases in each group according to the random number table method. The control group was given oxytocin to induce labor, and the observation group was given Cook cervical ripening balloon combined with oxytocin to induce labor. The cervical ripening effect, labor induction effect, labor duration, success rate of vaginal delivery, level of stress response indexes, and maternal and infant adverse outcomes during labor induction of the two groups were compared. Results: After induction of labor, the cervical Bishop score of the observation group was higher than that of the control group(P<0.05). The effective rate in promoting cervical ripeness of the observation group(100%) was higher than that of the the control group(85.71%)(P<0.05). The incubation period, the active stage, the second stage of labor and the total time of labor of the observation group were all shorter than those of the control group(P<0.05). The effective rate of induction in the observation group was 97.62%, which was higher than that of the control group （80.95%）(P<0.05). The rate of vaginal delivery in the observation group was 92.86%, which was higher than that of the control group (76.19%)(P<0.05). The level of stress response indexes catecholamine(CA) and cortisol(Cor) in the observation group were lower than those in the control group(P＜0.05). The incidence of adverse maternal and infant outcomes in the observation group was 7.14%, which was lower than that of the of the control group(28.57%)(P＜0.05), and there was no newborn death or sepsisoccurred in both two groups. Conclusion: Cook cervical ripening balloon combined with oxytocin is effective for term pregnancy induced labor, which is conducive to shorten the labor process, improve the success rate of induced labor and natural delivery, reduce the stress response to childbirth and the incidence of maternal and infant adverse outcomes, and has high safety.

Key words: Term pregnancy induced labor, Cook cervical ripening balloon, Oxytocin, Efficacy, Safety

中图分类号:

林文静, 李海波. 足月妊娠引产时应用宫颈Cook球囊联合缩宫素的有效性和安全性[J]. 中国医药导刊, 2021, 23(12): 896-901.

LIN Wenjing, LI Haibo. Efficacy and Safety of Cook Cervical Ripening Balloon Combined with Oxytocin in Term Pregnancy Induced Labor[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2021, 23(12): 896-901.

参考文献

[1]姚若冰,关静,申文娟,等.Foley′s尿管联合缩宫素及间苯三酚用于足月妊娠引产的有效性及安全性[J].贵州医药,2020,44(8):1269-1271.
     [2]胡娅萍,徐泽荣,欧阳银.宫颈Cook球囊联合缩宫素滴注与欣普贝生用于足月妊娠引产的临床效果比较[J].中国计划生育学杂志,2020,28(7):1044-1047.
     [3]胡社英,王春琴,余有妹,等.Cook宫颈扩张球囊联合缩宫素引产对母婴结局的影响研究[J].重庆医学,2020,49(6):977-980.
     [4]曹珊珊,裘桂静.COOK宫颈扩张球囊促宫颈成熟并引产的效果探究[J].中国性科学,2020,29(11):98-101.
     [5]谢幸.妇产科学[M]. 第8版.北京:人民卫生出版社,2013:62.
     [6]福建省卫生厅医政处.常见病临床诊治常规[M].厦门：厦门大学出版社,2001:406.
     [7]Laughon SK，Zhang J，Troendle J，et al.Using a simplified Bishop score to predict vaginal delivery[J].Obstet Gynecol,2011,117(4) :805-811.
     [8]黎燕,苏放明,高宇,等.宫颈扩张双球囊导管和控释地诺前列酮栓促宫颈成熟的比较研究[J].中国妇幼保健,2013,28(11):1822-1825.
     [9]张丹妮,刘琦,王丽.3种药物在足月妊娠引产中的临床效果对比[J].长春中医药大学学报,2019,35(5):953-956.
     [10]马瑶,贾红梅,刘海艳,等.足月妊娠宫颈评分≤4分的孕妇三种促宫颈成熟方法的效果比较[J].北京医学,2020,42(3):256-257.
     [11]马本红,谢娜.Foley尿管小水囊联合小剂量缩宫素用于低宫颈评分足月妊娠引产的效果分析[J].徐州医科大学学报,2019,39(11):815-818.
     [12]梁慧叶.低位水囊联合催产素在足月妊娠引产中的疗效观察[J].中国药物与临床,2020,20(12):2017-2018.
     [13]劳永霞,萧志辉.比较宫颈球囊和缩宫素促宫颈成熟在足月妊娠引产中的价值[J].中国性科学,2020,29(3):71-74.
     [14]胡婷婷,范淑丽,朱晓玲.瘢痕子宫经阴道试产使用缩宫素的研究进展[J].中国妇产科临床杂志,2020,21(6):651-653.
     [15]于娟.宫颈球囊扩张器对足月妊娠引产孕妇宫颈成熟、分娩以及母婴结局的影响[J].临床研究,2019,27(9):71-72.
     [16]任虹,曹玲玲.子宫颈扩张球囊在足月妊娠引产中的应用及其对产妇应激反应的影响[J].海南医学,2019,30(16):2092-2094.
     [17]刘琼珊,陈洁婷,范馥芳.COOK宫颈扩张球囊在引产中的安全有效性及患者满意度的相关研究[J].中国计划生育和妇产科,2020,12(9):37-41.
     [18]单震丽,许传露,阮晟铭,等.宫颈扩张球囊和前列腺素用于促宫颈成熟的回顾性对照研究[J].现代妇产科进展,2015,24(6):444-447.
     [19]王春香,麦浩山,陈静, 等.米索前列醇与COOK球囊对低宫颈评分孕妇促宫颈成熟疗效分析[J].中国计划生育和妇产科,2020,12(3):44-46.

快速检索引用检索图表检索高级检索