COOK球囊联合缩宫素在瘢痕子宫阴道试产促宫颈成熟中的应用价值  

Application value of COOK balloon combined with oxytocin in promoting cervical maturation during vaginal trial delivery of scar uterus

作　　者：冯宁 刘艳[1] FENG Ning;LIU Yan(Obstetrics and Gynecology Department,Xi'an Central Hospital,Xi'an 710061,China)

机构地区：[1]西安市中心医院妇产科,陕西西安710061

出　　处：《临床医学研究与实践》2021年第25期144-146,153,共4页Clinical Research and Practice

摘　　要：目的探讨COOK球囊联合缩宫素在瘢痕子宫阴道试产促宫颈成熟中的应用价值。方法选取2017年9月至2018年9月我院收治的72例瘢痕子宫足月妊娠产妇为研究对象,采用随机数字表法将其分为观察组与对照组,各36例。观察组采用COOK子宫颈扩张球囊联合缩宫素促进宫颈成熟并分娩,对照组采用缩宫素促进宫颈成熟并分娩。比较两组的促宫颈成熟效果、引产情况、产程、妊娠结局(新生儿Apgar评分、24 h出血量)及不良结局(宫颈裂伤、急性绒毛膜羊膜炎、新生儿窒息)发生情况。结果观察组的促宫颈成熟总有效率及经阴道分娩率明显高于对照组(P<0.05)。观察组的第一、二产程及总产程时间短于对照组(P<0.05);两组第三产程时间比较,差异无统计学意义(P>0.05)。观察组新生儿的1、5 min Apgar评分高于对照组(P<0.05);观察组产妇24 h出血量少于对照组(P<0.05)。观察组不良结局总发生率明显低于对照组(P<0.05)。结论在严格把控产妇适应证的前提下,相较于单纯应用缩宫素而言,COOK子宫颈扩张球囊联合缩宫素更有利于提高瘢痕子宫足月妊娠产妇阴道分娩成功率,降低重复剖宫产率,减少不良结局的发生。Objective To explore the application value of COOK balloon combined with oxytocin in promoting cervical maturation during vaginal trial delivery of scar uterus.Methods A total of 72 full-term pregnant women with scarred uterus who were admitted in our hospital from September 2017 to September 2018 were selected as the research objects and divided into observation group and control group by random number table method,with 36 cases in each group.The observation group used COOK cervical dilation balloon combined with oxytocin to promote cervical maturity and delivery,and the control group used oxytocin to promote cervical maturity and delivery.The effects of promoting cervical maturation,induced labor,labor process,pregnancy outcome(neonatal Apgar score,24 h bleeding volume)and adverse outcomes(cervical laceration,acute chorioamnionitis,neonatal asphyxia)were compared between the two groups.Results The total effective rate of promoting cervical maturity and the rate of vaginal delivery in the observation group were significantly higher than those in the control group(P<0.05).The time of the first stage of labor,the second stage of labor and the total stage of labor of the observation group were shorter than those of the control group(P<0.05);there was no significant difference in the time of the third stage of labor between the two groups(P>0.05).The Apgar scores of newborn at 1 and 5 min in the observation group were higher than those in the control group(P<0.05);the 24 h bleeding volume of pregnant women in the observation group was less than that in the control group(P<0.05).The total incidence of adverse outcomes in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Under the premise of strictly controlling the indications of pregnant women,compared with the simple application of oxytocin,COOK cervical dilatation balloon combined with oxytocin is more conducive to improve the success rate of vaginal delivery,reduce the rate of repeated cesarean section and the adverse

关 键 词：宫颈扩张球囊 缩宫素 瘢痕子宫 引导分娩 促宫颈成熟 妊娠结局 

分 类 号：R719.3[医药卫生—妇产科学]