COOK宮頸擴張球囊聯合縮宮素促進宮頸成熟和引產的臨床觀察

岑倩麗+吳言英+歐小燕+盧亙華

【摘要】目的：考察COOK宮頸擴張球囊聯合縮宮素促進宮頸成熟和引產的臨床效果。方法：選取宮頸不成熟的臨產婦90例，隨機分為觀察組和對照組，每組45例。對照組患者給予常規靜脈滴注縮宮素引產，觀察組患者采用COOK宮頸擴張球囊擴張后再行靜脈滴注。對比兩組宮頸成熟效果、臨產開始時間、產程、引產成功率和妊娠結局。結果：觀察組患者宮頸成熟有效率顯著高于對照組（χ2=4.05，P<0.05）。觀察組患者臨產開始時間、產程顯著短于對照組（P<0.01）。觀察組患者引產成功率和妊娠結局顯著優于對照組（P<0.05）。結論：COOK宮頸擴張球囊聯合縮宮素促進宮頸成熟更優、引產效果更佳，具有臨床應用價值。

【關鍵詞】引產；宮頸成熟；COOK宮頸擴張球囊

Clinical observation of cervical dilatation combined with oxytocin to promote cervical ripening and labor inductionCEN Qianli， WU Yanying， OU Xiaoyan， LU Genhua. No.1 Department of Gynecology， Maoming City Maternal and Children Health Care Hospital， Maoming 525000， Guangdong， China

【Abstract】Objectives： To investigate the clinical effect of COOK cervical dilatation combined with oxytocin to promote cervical ripening and labor induction. Methods： A total of 90 cervical immature parturient women were randomly divided into observation group and control group， 45 cases in each group. The control group received conventional intravenous oxytocin induced labor， and the patients in observation group received intravenous oxytocin after COOK cervical dilatation. The cervical ripening effects， labor start time， duration of labor， the induction success rate and pregnancy outcome were compared between the two groups. Results： The cervical maturity in observation group was significantly higher than that of control group （χ2=4.05， P<0.05）. The labor start time and duration of labor in observation group was significantly shorter than those in control group （P<0.01）. The induction success rate and pregnancy outcome of the observation group were significantly better than those of the control group （P<0.05）. Conclusion： COOK cervical dilatation combined with oxytocin can better promote cervical ripening and labor， which makes it worth for clinical application.

【Key words】Induced labor； Cervical ripening； COOK cervical dilatation balloon

【中圖分類號】R719.3【文獻標志碼】A

為降低剖宮產率，提高陰道分娩率成為產科目前面臨的一大問題。妊娠晚期引產成功與多種因素有關，其中宮頸成熟度起決定性作用，所以，引產前促宮頸成熟、提高宮頸評分是目前產科的重要課題之一[1，2]。COOK宮頸擴張球囊是通過機械壓力促進宮頸成熟的技術，與傳統催產素相比在促宮頸成熟引產中具有觀察方便、療效顯著等優勢[3]。同時，COOK宮頸擴張球囊促宮頸成熟操作簡單、安全，產婦引產過程中體位自如舒適，不良反應小，安全有效，引產成功率高，降低了剖宮產率[4]。本研究嘗試聯合應用兩種催產方式以進一步提升宮頸成熟效果，提升引產效率。

1資料與方法

1.1一般資料

隨機選取我院婦產科2013年7月至2015年7月收治的宮頸不成熟的臨產婦90例，入組標準：（1）單胎；（2）胎膜完整；（3）年齡18～35歲；（4）孕周36～42周。排除標準：（1）嚴重合并疾病；（2）拒絕入組研究。所有患者知情同意后將其按照數字表法隨機分為觀察組和對照組，每組45例。……