不同引产手段对足月胎儿生长受限引产效果的比较  

Comparison of the Effect of Different Methods of Inducing Labor for Growth Restriction of Full-Term Fetus

作　　者：颜明星 李丽英[1] 王金吉[1] YAN Mingxing;LI Liying;WANG Jinji(Department of Obstetrics,Fujian Maternal and Child Health Hospital/Fujian Medical University Women's and Children's Clinical Medical College,Fuzhou Fujian 350001,China)

机构地区：[1]福建省妇幼保健院/福建医科大学妇儿临床医学院产科,福建福州350001

出　　处：《中国卫生标准管理》2025年第2期29-33,共5页China Health Standard Management

摘　　要：目的 比较地诺前列酮和COOK子宫颈扩张球囊在足月胎儿生长受限(fetal growth restriction,FGR)妊娠期女性引产中的疗效和安全性,以指导其临床应用。方法 选取2017年1月—2021年12月福建省妇幼保健院收治的318例足月FGR妊娠期女性,其中165例采用地诺前列酮引产作为地诺前列酮组,153例采用COOK子宫颈扩张球囊引产作为COOK球囊组。比较2组临床指标、剖宫产指征、不良反应发生情况、新生儿情况。结果 地诺前列酮组促成熟后Bishop评分为(6.91±3.90)分,高于COOK球囊组的(5.82±1.32)分;地诺前列酮组用药至临产时间、用药至分娩时间分别为(9.73±4.82)h、(22.11±8.13)h,均短于COOK球囊组的(17.50±8.77)h、(30.27±12.28)h;地诺前列酮组阴道分娩率为83.6%,高于COOK球囊组的71.9%;使用缩宫素占比为32.7%,低于COOK球囊组的86.3%,差异有统计学意义(P <0.05)。地诺前列酮组剖宫产率为16.4%、引产失败率为7.4%,均低于COOK球囊组的28.1%、39.5%;地诺前列酮组胎儿窘迫发生率为77.8%,高于COOK球囊组的39.5%,差异有统计学意义(P <0.05)。地诺前列酮组子宫收缩过强、胎膜早破发生率分别为10.3%、7.3%,高于COOK球囊组的0.7%、1.3%,差异有统计学意义(P <0.05)。2组新生儿出生体质量、出生后1 min Apgar评分、新生儿窒息率(5 min Apgar评分≤7分)、入住新生儿重症监护室(neonatal intensive care unit,NICU)发生率、住院时间、新生儿肺炎、新生儿羊水吸入综合征发生率比较,差异无统计学意义(P> 0.05)。结论 在足月FGR妊娠期女性引产中使用地诺前列酮的引产疗效优于COOK子宫颈扩张球囊,能够有效缩短产程时间,提高阴道分娩率,且不会增加产时、产后并发症,母婴不良事件发生率低。Objective To compare the effect and safety of dinoprostone and COOK cervical dilatation balloon in induced labor for pregnant women with full-term fetal growth restriction(FGR)so as to guide the clinical application.Methods A total of 318 pregnant women with full-term FGR admitted to Fujian Maternal and Child Health Hospital were enrolled between January 2017 and December 2021,including 165 cases given dinoprostone as the dinoprostone group and 153 cases given COOK cervical dilation balloon for induced labor as the COOK balloon group.The clinical indexes,indications of cesarean section,occurrence of adverse reactions and neonatal conditions of the two groups were compared.Results Bishop score of dinoprostol group was(6.91±3.90)points,which was higher than(5.82±1.32)points of COOK balloon group.The time from medication to labor and from medication to delivery in dinoprostol group were(9.73±4.82)h and(22.11±8.13)h,respectively,which were shorter than(17.50±8.77)h and(30.27±12.28)h in COOK balloon group.The vaginal delivery rate in dinoprostol group was 83.6%,which was higher than 71.9%in COOK balloon group.The proportion of using oxytocin was 32.7%,which was lower than 86.3%in COOK balloon group,and the differences were statistically significant(P<0.05).The cesarean section rate and induction failure rate in dinoprostol group were 16.4%and 7.4%respectively,which were lower than 28.1%and 39.5%in COOK balloon group.The incidence of fetal distress in dinoprostol group was 77.8%,which was higher than 39.5%in COOK balloon group,and the differences were statistically significant(P<0.05).The rates of uterine hypercontractions and premature rupture of membranes in dinoprostol group were 10.3%and 7.3%,respectively,which were higher than 0.7%and 1.3%in COOK balloon group,and the differences were statistically significant(P<0.05).There was no significant difference in the birth weight,Apgar score at 1 min after birth,neonatal asphyxia rate(Apgar score≤7 points at 5 min),incidence of hospitalization in neonatal intensi

关 键 词：地诺前列酮 COOK子宫颈扩张球囊 引产 胎儿生长受限 小于胎龄儿 不良事件 

分 类 号：R714[医药卫生—妇产科学]