COOK宫颈球囊扩张器用于高危妊娠促宫颈成熟的效果观察

摘要

目的:观察COOK宫颈球囊扩张器用于高危妊娠促宫颈成熟的效果.方法:选择100例足月高危妊娠初产妇,按随机数字表分为观察组与对照组,各50例.观察组使用COOK宫颈球囊扩张器,对照组使用缩宫素.比较两组干预前后的宫颈Bishop评分、促宫颈成熟率、第一产程、第二产程、总产程、产后24h出血量、住院时间、引产成功率、阴道分娩率、宫颈裂伤、阴道血肿、产后出血发生率、新生儿体质量、Apgar评分、新生儿窒息率与窘迫率.结果:干预后观察组的宫颈Bishop评分高于干预前与对照组(P＜0.05).观察组促宫颈成熟率为76.00％,高于对照组(P＜0.05).观察组第一产程与总产程均短于对照组(P＜0.05),产后24h出血量与住院时间更低(P＜0.05).观察组引产成功率与阴道分娩率为74.00％、70.00％,均高于对照组(P＜0.05),两组新生儿体质量、Apgar评分、宫颈裂伤、阴道血肿、新生儿窘迫、新生几窒息发生率的差异均无统计学意义(P＞0.05).结论:COOK球囊宫颈扩张器在高危妊娠产妇中的应用可有效促宫颈成熟并扩张宫颈,缩短产程、减少出血并提高阴道分娩率,且不会增加宫颈裂伤、阴道血肿、新生儿窘迫与窒息,操作简单、安全有效,值得临床推广.%Objective To observe the effect of COOK cervical balloon dilator on the promotion of cervical ripening in high-risk pregnant women.Methods One hundred full-term high-risk pregnant women were selected and randomly divided into observation group and control group,50 cases in each group.The observation group was treated with COOK cervical balloon dilator,while the control group was treated with oxytocin.The Bishop scores before and after intervention,rate of cervical ripening,first stage of production process,second stage of production process,total production process,hemorrhage volume within 24 h after parturition,hospitalization time,success rate of labor induction,rate of vaginal delivery,the incidence of cervical laceration,vaginal hematoma and postpartum hemorrhage,neonatal body mass,Apgar score,rate of neonatal asphyxia,and incidence of neonatal distress were compared between the two groups.Results The cervical Bishop score in observation group was higher than that before intervention and that in control group (P＜0.05).The observation group showed a higher rate of cervical ripening (76.00％) than control group (P＜0.05).The first stage of production process and total production process of observation group were shorter than those of control group (P＜0.05),and the hemorrhage volume within 24 h after parturition,hospitalization time were lower than those in control group (P＜0.05).The success rate of labor induction and rate of vaginal delivery were 74.00％ and 70.00％ in observation group,higher than those in the control group (P＜0.05).No significant difference was found in neonatal body mass,Apgar score,incidence of cervical laceration,vaginal hematoma,neonatal distress and neonatal asphyxia (P＞0.05).Conclusion Applying COOK balloon cervical dilator in high-risk pregnant women can effectively promote cervical ripening and the expansion of the cervix,shorten the duration of labor,reduce bleeding and improve success rate of vaginal delivery,without increasing the incidence of cervical laceration,vaginal hematoma,neonatal distress and asphyxia.COOK balloon cervical dilator is easy to operate safe and effective,worthy of clinical promotion.