COOK宫颈扩张球囊临床使用的疗效评估  

Clinical efficacy of Cook cervical ripening balloon

作　　者：梁顺银[1] 周惠玲[1] 王苏[1] 胡淑君[1] 

机构地区：[1]广州医科大学附属第一医院妇产科,广东广州510120

出　　处：《广州医科大学学报》2015年第4期69-72,共4页Academic Journal of Guangzhou Medical University

基　　金：广州市医药科技项目(20131AO11138)

摘　　要：目的：探讨COOK宫颈扩张球囊应用于妊娠晚期单胎孕妇促宫颈成熟及引产的有效性及安全性。方法：收集广州医科大学附属第一医院妇产科2014年1月至2014年12月113例应用COOK宫颈扩张球囊孕妇的临床资料,按照放置球囊前的宫颈Bishop评分分为A组（Bishop评分≤3分,78例）和B组（Bishop评分4-5分,35例）,并收集同期直接使用小剂量缩宫素静滴的孕妇设为C组（Bishop评分4~5分,35例）,分别比较3组资料中宫颈Bishop评分、引产成功率、分娩情况及对母婴结局的影响。结果：3组资料中2种方法均能在不同程度上达到促宫颈成熟的目的,其中,A、B两组使用COOK宫颈扩张球囊促宫颈成熟有效率均显著高于C组,差异有统计学意义（P〈0.05）。A、B两组第一产程时间显著少于C组、引产成功率显著高于C组、剖宫产率显著低于C组,差异均有统计学意义（P〈0.05）。A组与B组促宫颈成熟有效率（A组92.31%、B组100%）、阴道分娩率（A组82.05%、B组85.71%）随宫颈初始评分逐渐递增,即宫颈初始评分越高,促宫颈成熟有效率及引产率越高,差异有统计学意义（P〈0.05）。3组对母婴结局中产后出血、新生儿评分的比较差异无统计学意义（均P〉0.05）。结论：COOK宫颈扩张球囊应用于妊娠晚期单胎孕妇促宫颈成熟及引产有效、安全,可有效提高引产成功率,降低剖宫产率,值得临床推广应用。Objective： To investigate the effectiveness and safety of COOK cervical ripening balloon used in the third trimester pregnant women to promote cervical mature and induce labor. Method： From January 2014 to December 2014,113 subjects receiving placement of COOK cervical ripening balloon at the Department of Obstetrics and Gynecology,the First Affiliated Hospital of Guangzhou Medical College were studied. According to the cervical Bishop score before placing the balloon,the patients were divided into group A（ Bishop score ≤3,78 cases） and group B（ Bishop score： 4-5,35 cases）,and subjects receiving low dose intravenous oxytocin during the same period directly were set as group C（ Bishop score： 4- 5,35 cases）. The effects of cervical Bishop score,success rate of induced labor,and delivery conditions on maternal-infant outcome were compared in the three sets of data. Result： The two methods applied in the three groups can both achieve the purpose of enhancing cervical ripening in varying degrees. The effectiveness of group A and B（ using COOK cervical ripening balloon） in promoting cervical mature is significantly higher than that of group C（ P〈0. 05）. The duration of the first stage of labor in group A,B is significantly shorter than group C,the induced labor rate of group A,B is significantly higher than group C,and the cesarean delivery rate of group A,B is significantly lower than that of group C,the differences are all statistically significant（ P〈0. 05）. Therefore,compared with low dose intravenous oxytocin,COOK cervical ripening balloon can be more effective in promoting cervical mature and improving the rate of induced labor. As the initial Bishop？ score increases,the efficacy in enhancing cervical ripening（ group A,92. 31% 、group B,100%）,and rate of vaginal delivery（ group A,82. 05% 、group B,85. 71%） rise gradually,that is,the higher initial Bishop？ score indicates more effective cervical ripening and higher vaginal delivery rate,the differences are of s

关 键 词：COOK宫颈扩张球囊 宫颈BISHOP评分 促宫颈成熟 引产 缩宫素. 

分 类 号：R719.3[医药卫生—妇产科学]