两种不同促宫颈成熟方法在足月妊娠初产妇中的应用  

Application of two different methods of promoting cervical ripening in full-term pregnancy primipara

作　　者：曹妮 米阳 

机构地区：[1]西北妇女儿童医院,陕西西安710061

出　　处：《中国妇幼健康研究》2017年第12期1685-1687,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的比较COOK球囊与欣普贝生在足月妊娠初产妇中的应用效果。方法选取118例足月妊娠引产的初产妇,按照随机数字表法分为研究组(应用COOK球囊)和对照组(应用欣普贝生),各59例。观察并比较两组产妇使用后的宫颈Bishop评分、剖宫产情况(剖宫产率、引产失败、产程异常、胎儿窘迫)、分娩情况(催产素使用情况、产后出血情况、)及新生儿结局(新生儿体重、Apgar评分)等指标。结果 (1)两组产妇使用后的Bishop评分均高于使用前(t值分别为-17.83、-19.89,均P<0.05);两组产妇使用前、后的Bishop评分的差异无统计学意义(t值分别为-0.09、-0.27,均P>0.05);研究组产妇使用后的自然临产率显著低于对照组(χ~2=28.41,P<0.05);(2)研究组产妇剖宫产率为8.47%,显著低于对照组的23.73%(χ~2=5.08,P<0.05),研究组产妇胎儿窘迫、引产失败的发生率均显著低于对照组(χ~2值分别为4.83、4.24,均P<0.05),而产程异常的发生率高于对照组(χ~2=4.83,P<0.05);(3)研究组产妇使用至临产的时间、总产程时间、催产素使用率均高于对照组(t/χ~2值分别为4.58、5.07、4.24,均P<0.05),产后出血率、急产的发生率均低于对照组(χ~2值分别为5.98、9.74,均P<0.05);两组产妇的产后出血量、软产道损伤、住院时间的差异无统计学意义(t/χ~2值分别为-1.90、0.44、1.43均P>0.05);(4)研究组新生儿1分钟Apgar评分≤5分低于对照组(χ~2=4.83,P<0.05),两组的新生儿体重、5分钟Apgar评分≤5分的差异无统计学意义(t/χ~2值分别为-0.47、0.00,均P>0.05)。结论给予足月妊娠产妇采用COOK球囊能有效促进宫颈的成熟,产程较欣普贝生长,但使用COOK球囊能降低中转剖宫产率、产后出血、胎儿窘迫发生率、软产道损伤率等,较欣普贝生温和,安全性高,值得推广应用。Objective To compare the effect of COOK balloon and dinoprostone on full-term pregnancy primipara.Methods Totally118 cases of full-term pregnancy primipara for labor induction were randomly divided into study group（COOK balloon）and control group（dinoprostone）by random number table method with 59 cases in each group.The cervical Bishop score,cesarean section（cesarean section rate,failure of labor induction,abnormal labor,fetal distress）,childbirth（use of hormone oxytocin,postpartum hemorrhage）,and neonatal outcomes（neonatal weight,Apgar score）were observed and compared between two groups.Results The Bishop scores of two groups after use were higher than those before use（t value was-17.83 and-19.89,respectively,both P〈0.05）.There were no significant differences in Bishop scores between two groups before and after use（t value was-0.09 and-0.27,respectively,both P〈0.05）.After use the natural delivery rate of the study group was significantly lower than that in the control group（χ~2=28.41,P〈0.05）.The rate of cesarean section was 8.47%in the study group,which was lower than 23.73%in the control group（χ~2=5.08,P〈0.05）.The incidence of fetal distress and failure of induction labor in the study group were lower than those in the control group（χ~2 value was 4.83 and 4.24,respectively,both P〈0.05）,but incidence of abnormal labor was higher（χ~2=4.83,P〈0.05）.Interval between use and labor,total labor time,and the use of hormone oxytocin in the study group were higher than those in the control group（t/χ~2 value was 4.58,5.07 and 4.24,respectively,all P〈0.05）,but the incidence of postpartum hemorrhage and rate of acute production were lower（χ~2 value was 5.98 and 9.74,respectively,both P〈0.05）.There were no significant differences in postpartum hemorrhage,soft birth canal injury and hospitalization time between two groups（t/χ~2 value was-1.90,0.44 and 1.43,respectively,all P〈0.05）.Patients with Apgar score of 1 minute ≤ 5 points in the study grou

关 键 词：足月妊娠 促宫颈成熟 COOK球囊 欣普贝生 临床效果 

分 类 号：R714.1[医药卫生—妇产科学]