宫颈扩张球囊及控释地诺前列酮栓用于促宫颈成熟及引产的对比研究

Comparative study between cervical dilation balloon and controlled-release dinoprostone suppository in promoting cervical maturity and inducing labor

目的比较宫颈扩张球囊与控释地诺前列酮栓在促进产妇宫颈成熟及引产方面的治疗效果。方法选取在浙江省瑞安市妇幼保健院妇产科接受治疗的单胎头位妊娠的200例孕妇作为研究对象,随机分为对照组和研究组。对照组采用控释地诺前列酮栓,研究组采用宫颈扩张球囊。对两组产妇治疗过程中的Bishop评分情况、促宫颈成熟及引产效果以及分娩情况进行统计学分析。结果研究组治疗后4h、8h以及12h的Bishop评分均显著高于对照组(t值分别为9.12、12.35、18.95,均P<0.05)。研究组中患者促宫颈成熟的总有效率及引产成功率均显著高于对照组(χ2值分别为10.23、15.18,均P<0.05)。两组孕妇治疗至临产时间、第二产程以及新生儿Apgar评分均无显著性差异(t值分别为1.01、0.45、1.23,均P>0.05)。研究组的第一产程时间、总产程及产后出血量均显著低于对照组(t值分别为4.51、4.78、5.12,均P<0.05),研究组产妇的阴道分娩率显著高于对照组(χ2=9.45,P<0.05),且胎儿窘迫发生率显著低于对照组(χ2=13.24,P<0.05)。结论宫颈扩张球囊用于促宫颈成熟的效果明显优于控释地诺前列酮栓,且不良反应发生率低,安全性较高。

Objective To compare the therapeutic effects of cervical dilatation balloon and controlled-release dinoprostone suppository in promoting cervical maturity and inducing labor. Methods A total of 200 singleton pregnant women in department of obstetrics and gynecology of Maternal and Child Health Hospital of Ruian City in Zhejiang Province were selected as research objects. They were randomly divided into control group and study group. As for women in the control group, they received controlled-release dinoprostone suppository, while pregnant women in the study group received cervical dilation balloon. Statistical analysis concerning Bishop score during treatment, therapeutic outcomes considering cervical maturity as well as labor induction and conditions of delivery were carried out in both groups. Results The Bishop scores at 4h, 8h and 12h after treatment in the study group were significantly higher than those in the control group （t value was 9.12, 12.35 and 18.95, respectively, all P 〈 0.05）. The total effective rate of promoting cervical maturity and success rate of labor induction were remarkably higher in the study group （X2 value was 10.23 and 15.18, respectively, both P 〈 0.05 ）. There was no significant difference between two groups in the interval between treatment and labor, second stage of labor, and neonatal Apgar scores （t value was 1.01 , 0. 45 and 1.23, respectively, all P 〉 0.05 ）. The first stage of labor, total stage of labor and blood loss after delivery were found to be much lower in the study group than in the control group （t value was 4.51,4.78 and 5.12, respectively, all P 〈0.05）. The rate of vaginal delivery in the study group was significantly higher than that in the control group （X2 = 9.45, P 〈 0.05 ）. Besides, the study group had a significantly lower incidence rate of fatal distress than the control group （X2 = 13.24, P 〈 0.05 ）. Conclusion Cervical dilation balloon is superior to controlled-release dinoprostone suppositories in promoting cervical maturity with lower incidence rate of adverse reactions and greater drug safety.