双球囊在子痫前期及子痫患者引产中的应用  

Application of the double balloon device in labor induction for women with preeclampsia and eclampsia

作　　者：孙艳梅[1] 范翠芳[1] 陈建华[1] 段志珍[1] 

机构地区：[1]武汉大学人民医院,武汉430060

出　　处：《中国医师杂志》2013年第9期1187-1189,共3页Journal of Chinese Physician

摘　　要：目的探讨双球囊应用于子疴前期及子疴患者引产的有效性及安全性。方法回顾性分析本院产科住院诊治的子疴前期及子痢患者共101例，其中选择性剖宫产64例，37例Bishop评分≤5分者自愿采用双球囊导管促宫颈成熟后阴道试产，比较双球囊置人前后宫颈成熟度变化，分析阴道分娩情况及分娩结局。结果37例子痢前期及子痫患者置入水囊前宫颈Bishop评分[（3．38±0．50）分]明显低于置入水囊后[（6．44±0．63）分]，其差异有统计学意义（t=23．54，P〈0．01）；水囊置入前后血压无明显变化[收缩压（158．38±13．89）mmHgVS（162．48±12．56）mmHg，P〉0．05；舒张压（112．71±15．53）mmHgV8（108．19±8．37）mmHg，P〉0．05]，其阴道分娩率为89．2％（33／37），总产程（5．8±0．63）h，与选择性剖宫产相比，双球囊促宫颈成熟后阴道分娩者失血量明显减少（t=9．19，P〈0．01），产后恢复快，住院时间短（t=11．18，P〈0．01），新生儿出生体质量低（t=2．96，P〈0．01），新生儿出生后1minApgar评分值高（t=2．34，P〈0．05）。结论子痢前期及子痢患者采用双球囊置入能有效促宫颈成熟和扩张宫颈，其阴道分娩成功率高，且不增加新生儿窒息等并发症，其方法安全、有效。Objective To evaluate the efficacy and safety of labor induction by the double balloon device in women with preeclampsia and eclampsia. Methods Labor induction was carried out in 37 women with preeclampsia and eclampsia from July 2011 to November 2012. All the labor inductions were performed using the double balloon device. Results The cervical Bishop scores of 37 cases of patients with pre- eclampsia and eclampsia were significantly lower before using double balloon device [ （3.38 ± 0. 50 ） scores ] compared with after using double balloon device [ （6.44± 0. 63） scores ] with a statistically significant difference （ t = 23.54, P 〈 0. 01 ）. Blood pressure had no obvious change before and after using doub- le balloon device [ SBP （ 158.38 ±13.89） mmHg vs （ 162. 48 ± 12. 56） mmHg, P 〉 0.05, and SDP （ 112. 71 ± 15.53） mmHg vs （ 108. 19 ± 8.37） mmHg, P 〉 0.05 ]. The rate of vaginal delivery was 89. 2% （33/ 37）, and the total hours of labor were （5.8 ± 0. 63 ） h. Compared with selective cesarean section, vaginal delivery after double balloon to promote cervical mature had less blood loss （ t = 9. 19, P 〈 0. 01 ）, quicker postpartum recovery, shorter hospitalization time （ t = 11.18, P 〈 0. 01 ）, lower birth body mass （ t = 2. 96, P 〈 0. 01 ） and higher scores of 1 minutes Apgar score （ t = 2. 34, P 〈 0. 05）. Conclusions The double balloon device appeared to be a safe and effective method to induce labor in women with preeclamp- sia and eclampsia. Wide scale studies and further use of the device for labor induction in women with pre- eclampsia and eclampsia were warranted.

关 键 词：气囊 引产/方法 先兆子癎 子癎 宫颈成熟 

分 类 号：R719.3[医药卫生—妇产科学] R714.245[医药卫生—临床医学]