COOK球囊加米索前列醇与单独使用米索前列醇在中孕疤痕子宫引产中的比较  

Comparison of COOK balloon plus misoprostol with misoprostol alone in inducing labor in midtrimester pregnancy scarred uterus

作　　者：曾欢英 苏慧明 钟志文 郑敏旋 黄星 Zeng Huanying;Su Huiming;Zhong Zhiwen;Zheng Minxuan;Huang Xing(Gynaecology and Obstetrics Department of Guangzhou Panyu Central Hospital,Guangzhou,Guangdong 511400,China)

机构地区：[1]广州市番禺区中心医院妇产科,广东广州511400

出　　处：《医药前沿》2020年第26期28-30,共3页Journal of Frontiers of Medicine

摘　　要：目的:比较中孕疤痕子宫引产中使用COOK球囊加米索前列醇(通用名:子宫颈扩张球囊,美国COOK公司)的效果是否优于单独使用米索前列醇。方法:回顾性分析2013年1月-2019年12月因各种原因于广州市番禺中心医院妇科进行中孕引产的疤痕子宫孕妇98例,孕周14+0~27+6周,按照不同的处理方法分为1.研究组:联合使用COOK球囊加米索前列醇组即CRB组(53例);2.对照组:即单独使用米索前列醇组(45例)。分析两组有效率,引产至分娩时间,并发症,组织物残留等的差异。结果:两组一般资料年龄、产次、孕妇体重差异无统计学意义,孕周比较差异有统计学意义(21±3.8w vs 17.4±3.4w,P﹤0.001),CRB组孕周大于米索组。住院时间,发生并发症的发生率差异均无统计学意义,引产至分娩时间(27.5±15.1h vs 14.4±12.0h,P﹤0.001),组织物残留发生率[32(60.4%)vs 13(28.9%),P<0.002]差异有统计学意义,CRB组高于米索前列醇组。在住院费用方面CRB组的住院费高于米索组(4654±791 vs 2941±960,P<0.001),差异有统计学意义。在CRB组中有两例通过放置球囊即出现规律宫缩,在未使用米索前列醇的情况下排胎,发生率3.77%,其余病例均需在拔除球囊后使用米索前列醇。两组均未见有严重并发症发生。结论:在中孕疤痕子宫引产中使用COOK球囊是安全有效的但与单独使用米索前列醇相比,患者无明显获益。COOK球囊可以作为中孕疤痕子宫引产中一种可以选择的方法,但不必用作常规的方法。Objective To compare the effect of COOK balloon(general name:cervical dilation balloon,COOK company,THE United States)plus misoprostol with misoprostol alone during labor induction of middle pregnancy scarred uterus.Methods A retrospective analysis was performed on 98 pregnant women with scarred uterus who underwent induced labor in gynecology department of Guangzhou Panyu Central Hospital from January 2013 to December 2019 for various reasons,14+0~27+6 weeks gestational age,and they were divided into two groups according to different treatment methods.Study group:COOK balloon plus misoprostol group,CRB group(53 cases);2.Control group:misoprostol group alone(45 cases).The differences of effective rate,induction to labor time,complications and tissue residue between the two groups were analyzed.Results There were no statistically significant differences in the general information of the two groups in age,parity,and weight of maternal.The difference in gestational age was statistically significant(21±3.8w vs 17.4±3.4w,P﹤0.001).The gestational age of CRB group was greater than miso group.There were no statistically significant difference in hospitalization time and the incidence of complications.The time from induction to delivery(27.5±15.1h vs 14.4±12.0h,P<0.001),the incidence of tissue residues[32(60.4%)vs 13(28.9%),P<0.002]and the hospitalization costs(4654±791 vs 2941±960,P<0.001)were statistically significant.The CRB group was higher than the misoprostol group.No serious complications occurred in both groups.The patients who did not delivery in 30 hours were successfully induced by continuing to use misoprostol.Conclusion Using the COOK balloon in termination of scarred uterus midtrimester pregnancy is effective and safe.But there was no significant additional benefit of using a COOK balloon.COOK balloon can be used as an alternative method of inducing labor in midtrimester scar uterus,but does not have to be used as a routine method.

关 键 词：疤痕子宫 中孕引产 COOK球囊 

分 类 号：R719.3[医药卫生—妇产科学]