足月妊娠三种引产方法的临床对比分析  

A Clinical Comparative Analysis of Three Methods in Induction of Labor in Patients with Full Term Pregnancy

作　　者：高霞[1] 张毅[1] 李咏梅[1] 

机构地区：[1]湖北医药学院附属人民医院妇产科,湖北十堰442000

出　　处：《湖北医药学院学报》2015年第2期139-143,共5页Journal of Hubei University of Medicine

摘　　要：目的：探讨COOK球囊、控释地诺前列酮栓（欣普贝生）与催产素用于促宫颈成熟及引产的有效性及安全性。方法：选择2013年1月-2014年10月在本院住院治疗的,有引产指征的孕妇294例,随机平均分为球囊组、欣普贝生组和催产素组,观察3组引产成功率、用药至临产时间、产程时间、分娩方式和结局等。结果：⑴宫颈Bishop评分≤3分者,欣普贝生组引产成功率总有效率（88.9%）显著高于球囊组（78.9%）,差异有统计学意义（P〈0.05）,而催产素组总有效率仅为37.8%,与欣普贝生组及球囊组比较差异均有统计学意义（P〈0.01）;宫颈Bishop评分为4~5分者,欣普贝生组与球囊组引产成功率总有效率（88.5%vs.89.6%）比较差异无统计学意义（P〉0.05）,而催产素组（43.2%）明显低于球囊组及欣普贝生组,差异有统计学意义（P〈0.01）;宫颈Bishop评分为6~7分者,三组的总有效率差异无统计学意义（P〉0.05）;⑵球囊组和欣普贝生组的阴道分娩率明显高于催产素组,产后24 h出血量显著少于催产素组,差异有统计学意义（P〈0.05）;三组均无新生儿窒息情况发生,新生儿体质量及脐动脉p H值比较,三组亦无差异（P〉0.05）;⑶经阴道分娩的三组产妇比较,球囊组与欣普贝生组诱发临产时间、第一产程、总产程及住院时间方面差异无统计学意义（P〉0.05）,但球囊组第二产程时间明显短于欣普贝生组,差异有统计学意义（P〈0.05）,而球囊组与欣普贝生组诱发临产时间、第一、二产程、总产程及住院时间均短于催产素组,差异有统计学意义（P〈0.05）。结论：对于宫颈Bishop评分≤5分者,与催产素组相比,使用控释地诺前列酮栓（欣普贝生）或COOK球囊可更加简便、安全、有效的确保引产成功;而对于Bishop评分≥6分者,三者的引产效果相似,产科医师可以根据孕妇实际情况合理利用。Objective To compare the efficacy and safety of COOK balloon catheter, dinoprostone （Propess） and oxytocin suppositories in cervical ripening and induction of labor. Methods From January 2013 to October 2014 ,total 294 primipa- raes meeting the indications of induced labor were enrolled and randomly divided into three groups, COOK balloon group, Propess group and oxytocin group. The effective rates of induced labor, time from administration to give birth, labor time, fe- tus delivery methods and outcomes were observed. Results （1）For patients with cervical Bishop score of less than or equal to 3 points,the effective rate of Propess group（88.9% ） was significantly higher than that of COOK balloon group（78.9% ）, but the effective rate of oxytoein group was only 37.8% and obviously lower than the other two groups（P 〈0. O1 ）. For pa- tients with cervical Bishop score of 4 -5 points,the effective rates of Propess group and COOK balloon group（88.5% vs. 89.6% ） had no significant difference （ P 〉 0. 05 ）, but the effective rate of oxytoein group was 43.2% and obviously lower than the other two groups （P 〈 0.01 ）. For patients with cervical Bishop score of 6 - 7 points, the effective rates of the three groups （ 88.5 % vs. 89.6% ） had no significant differences （ P 〉 0. 05 ）. （2）The vaginal delivery rates of COOK balloon group and Propess group were significantly higher than that of oxytocin group, but the blood loss at postpartum 24 hours in above two gorups were significantly lower than that of oxytoein group（P 〈0.05 ）. Neonatus asphyxia had not happened,the weight of neonatus and pH value of umbilical artery had no difference during three groups （ P 〉 0. 05 ）. （3）For the vaginal delivery parturients in three groups, the induced labor time, first labor, total labor and hospitalization time between COOK balloon group and Propess group had no significant difference（ P 〉 O. 05 ）, but the second labor of balloon group was significantly shorter than th

关 键 词：COOK宫颈扩张双球囊 控释地诺前列酮栓(欣普贝生) 缩宫素 促宫颈成熟 足月引产 

分 类 号：R719.3[医药卫生—妇产科学]