缩宫素与米索前列醇分娩诱导对脐带血气参数及新生儿结局的影响  

Effect of delivery induction with oxytocin and misoprostol on cord blood gas parameters and neonatal outcomes

作　　者：张峰莉 方宏桂 王中显 龚利 冉薇 Zhang Fengli;Fang Honggui;Wang Zhongxian;Gong Li;RanWei

机构地区：[1]湖北省第三人民医院妇产科,湖北武汉430030

出　　处：《新疆维吾尔医学专科学校学报》2024年第3期48-57,共10页

摘　　要：目的探讨缩宫素与米索前列醇分娩诱导时对脐带血气参数及新生儿结局的影响。方法选取湖北省第三人民医院2020年1月至2022年12月住院分娩产妇210例,根据受试者意愿以及入院时进行宫颈Bishop评分数值进行分组,分三组:米索前列醇组82例,采用米索前列醇分娩诱导;缩宫素组78例,采用缩宫素分娩诱导;无诱导组50例。用雅培血气分析仪i-STAT300进行新生儿血气分析,并记录新生儿的1分钟和5分钟Apgar评分,进入新生儿重症监护病房(NICU)例数。结果三组患者脐动脉血气分析中PH、PCO2、BE值比较,差异无统计学差异(P>0.05)。三组患者出生新生儿1min Apgar、5min Apgar及进NICU数目比较,差异无统计学差异(P>0.05);三组患者脐动脉血气分析中PO2比较,差异有统计学差异(P<0.01)。利用单因素分析及分层分析发现,孕妇年龄、出生体重、PO2是出生婴儿血气分析PH值、BE值下降的高危因素,有统计学差异(P<0.05)。在运用多因素回归方程调整了高危因素对于PH值、BE值的影响后,三组孕妇出生婴儿血气分析PH值、BE值比较,差异无统计学意义(P>0.05)。缩宫素发生子宫过度刺激率机率为8.97%,胎儿窘迫率为10.26%。米索前列醇组有较低的子宫过度刺激率(6.10%)和胎儿窘迫率(7.32%),两组比较差异无统计学差异(P>0.05)。结论:应用缩宫素和米索前列醇进行分娩诱导,对新生儿预后干扰小,安全性较高。Objective To explore the effects of chtotocin and misoprostol on cord blood gas parameters and neonatal outcomes.Method A total of 210 women who gave birth in hospital from January 2020 to December 2022,were selected and divided into three groups according to the willingness of the subjects and the value of the cervical Bishop Scores at the time of admission:misoprostol group(82 cases);oxytocin group(78 cases).There were 50 cases in non induction group.Use the i-STAT300 blood gas analyzer for neonatal blood gas analysis.The Apgar scores of 1 minute and 5 minutes of each newborn were recorded,as well as the list of those who entered NICU(neonatal intensive care unit).Result There was no significant difference in PH,PCO2 and BE among the three groups(P>0.05).There was no significant difference in Apgar at 1 min,Apgar at 5 min and the number of Nicu(P>0.05),but there was significant difference in PO2(p<0.01).Using univariate analysis and stratified analysis,it was found that maternal age,birth weight and PO2 were the risk factors of PH and BE decline in blood gas analysis,which were significantly different(P<0.05).After adjusting the influence of high risk factors on PH and BE by using multiple regression equation,there was no significant difference in blood gas analysis of PH and BE among the three groups(P>0.05).The incidence of uterine hyperstimulation and fetal distress was 8.97%and 10.26%respectively.The rate of uterine hyperstimulation(6.10%)and fetal distress(7.32%)in misoprostol group were lower than those in control group(P>0.05).Conclusion:Using oxytocin and misoprostol to induce labor has little influence on the prognosis of neonates and is safe.

关 键 词：缩宫素 米索前列醇 宫颈Bishop Scores 分娩诱导 血气参数 新生儿结局 

分 类 号：R714[医药卫生—妇产科学]