cook球囊在足月妊娠初产妇促宫颈成熟引产中的应用.docVIP

COOK球囊在足月妊娠初产妇促宫颈成熟引产中的应用 　　[摘要]目的 探究COOK球囊和米索前列醇在足月妊娠初产妇引产前促进宫颈成熟中的临床效果。方法 选择2014年7月～2016年7月在我院引产的106例足月妊娠初产妇，按照随机数字法分为实验组和对照组，各53例。引产中，实验组采用COOK球囊，对照组采用米索前列醇。比较两组患者宫颈Bishop评分及促宫颈成熟的总有效率；比较引产时间、分娩情况、母儿结局及不良反应的发生情况。结果 实验组促宫颈成熟总有效率和阴道分娩率均显著高于对照组（P0.05）；实验组产后出血、软产道损伤及不良反应发生率均低于对照组，差异有统计学意义（P 　　[关键词]COOK球囊；米索前列醇；宫颈成熟；引产 　　[中图分类号] R719.3 [文献标识码] A [文章编号] 1674-4721（2017）06（b）-0077-03 　　[Abstract]Objective To explore the effect of COOK balloon in promoting cervical mature during induced labor of full-term pregnancy mothers.Methods From July 2014 to July 2016，106 cases of full-term pregnancy in our hospital were randomly divided into the experimental group and the control group，53 cases in each group.The experimental group was given the COOK balloon and the control group was given the Misoprostol during the labor induction.The cervical Bishop score and the total effective rate of maturing cervix of patients in the two groups were compared；the duration of induced abortion，delivery conditions，maternal-fetal outcome，adverse reaction were compared between the two groups.Results The total effective rate of maturing cervix and vaginal delivery rate of the experimental group were significantly higher than those of the control group （P0.05）.The postpartum hemorrhage，injury of soft birth canal and adverse reaction of the experimental group were lower than those of the control group，the differences were statistically significant（P0.05），具有可比性。所有患者均同意参与本研究并签署知情同意书，本研究已经我院医学伦理委员会批准。 　　1.2方法 　　术前仔细核对引产指征及预产期，嘱患者排空膀胱，取截石位，充分消毒外阴、阴道，窥阴器充分暴露宫颈，无菌处理宫颈口及穹隆部。实验组采用COOK球囊（美国库克，J-CRB-184000），将宫颈扩张球囊置入宫腔，然后用40 ml无菌生理盐水充盈子宫球囊，充盈后将球囊向外拉至子宫球囊紧贴宫颈内口，此时可见阴道球囊位于宫颈外口，用20 ml无菌生理盐水充盈阴道球囊，并依次增加球囊内液体量，每次20 ml，直至每个球囊内液体量为80 ml，充入液体过程中观察产妇情况。球囊放置成功后胎监2 h并开始计时，无自然分娩产妇12 h后取出球囊予催产素引产[3]，若患者排尿困难或腹痛明显难以忍受，则宫腔及阴道内球囊各抽出20 ml无菌生理盐水[4]，若胎心异常、引产失败改行剖宫术[5]。对照组采用米索前列醇（浙江仙琚制药股份有限公司，国药准字方法，50 μg药剂口服，每4小时1次直至临产，总时长不超过24 h，观察产妇和胎心，若引产失败改行剖宫术。两组患者治疗过程中均由专人陪护，在治疗前及治疗后24 h均需行宫颈Bishop评分[6]。 　　1.3观察指标 　　观察两组患者