地诺前列酮栓与COOK宫颈扩张球囊用于促宫颈成熟的回顾性对照研究  

Retrospective controlled study of prostaglandin E_2 and COOK cervical dilation balloon for promote cervical ripening

作　　者：娄水平 李文霞[1] LOU Shui-ping;LI Wen-xia(Maternal and Child Health Hospital of Changsha City,Hunan 410007,China.)

机构地区：[1]长沙市妇幼保健院,长沙410007

出　　处：《中国处方药》2018年第5期9-11,共3页Journal of China Prescription Drug

摘　　要：目的探讨地诺前列酮栓和宫颈扩张球囊(COOK球囊)用于孕足月宫颈条件不成熟的孕妇引产的有效性与安全性比较。方法回顾性分析2016年1月~2016年12月长沙市妇幼保健院收治使用地诺前列酮栓或COOK宫颈扩张球囊引产的1 023例足月妊娠孕产妇(宫颈Bishop评分<6分)的临床资料,采用t、χ~2检验或Fisher精确概率法比较两种方法的临产时间及总产程时间,并对促宫颈成熟率、中转剖宫产率、胎儿窘迫、绒毛膜羊膜炎、发生过频宫缩率等方面的差异。结果地诺前列酮栓组与COOK球囊组在放药或放球囊至临产、总产程时间上比较,地诺前列酮栓组时间均明显短于球囊组[(7.4±0.9)h vs.(16.0±3.2)h,P<0.01;(8.3±1.0)h vs.(10.0±1.8)h,P<0.05]。地诺前列酮栓组在中转剖宫产率,胎儿窘迫发生率,使用硫酸镁率上均明显高于COOK球囊组(P<0.05);COOK球囊组在阴道分娩率、人工破膜率、使用缩宫素率,绒毛膜羊膜炎上均明显高于地诺前列酮栓组(P<0.05);两组产妇的促宫颈成熟率及引产失败率均无明显统计学差异。结论地诺前列酮栓和COOK球囊对于宫颈评分<6分需引产终止妊娠的足月妊娠产妇均安全、有效。地诺前列酮栓起效快,产程时间短,但可能出现过强过频宫缩,甚至出现胎儿窘迫。COOK球囊作用温和,效果确切,但有发生绒毛膜羊膜炎等风险。Objective The aim of this study was to compare the effectiveness and safety of prostaglandin E2 and COOK cervical ripening balloon for labor induction in full-term pregnant women with immature cervix. Methods The medical documents of 1 023 term pregnant women（Bishop score 6） induced by prostaglandin E2 or COOK cervical ripening balloon between January and December of 2016 in Changsha Hospital Maternal and Child Health Care were reviewed retrospectively. The t test and χ~2 or Fisher＇exact test were used to compare labor onset time, labor time, the rate of Cervical ripening rate, the rate of transit caesarean section, the rate of fetal distress, the rate of chorionic amnionitis, frequency contraction between two groups. Results The time from labor induction to active labor onset and total labor time were significantly shorter in the PGE2 group than in those COOK cerrical ripening ballon group[（7.4±0.9）h vs.（16.0±3.2） h,P〈0.01;（8.3±1.0）h vs.（10.0±1.8） h,P〈0.05];There were statistically significant differences in the rate of vaginal delivery, the rate of transit caesarean section,the rate of fetal distress, the rate of chorionic amnionitis, the use of oxytocin,the use of magnesian sulfate in the two groups. the rate of transit caesarean section, the rate of fetal distress, the use of magnesian sulfate were significant higher in the PGE2 group than COOK ballon group. The rate of vaginal delivery,the use of oxytocin, the rate of chorionic amnionitis were significant higher in the COOK ballon group than those in the PGE2 group.There were no statistically significant difference in the rate of cervical ripening and the rate of induction failure in the two groups.Conclusion It was safe and efficient of therapeutic methods of prostaglandin E2 and COOK cervical ripening balloon for labor induction in full-term pregnant women with immature cervix（Bishop score 〈6）. The prostaglandin E2 was quickly efficient and shorter stages of labor, but it can happen to over frequency uterine contraction

关 键 词：地诺前列酮栓 COOK宫颈扩张球囊 促宫颈成熟 引产 

分 类 号：R719.3[医药卫生—妇产科学]