产后妇康方辨证加减联合延长放置宫颈扩张球囊对阴道分娩引产指征孕妇预后的影响

Effects of Postpartum Modified Fukang Decoction Combined with Prolonged Indwelling of Cervical Dilatation Balloon on Prognosis of Pregnant Women with Vaginal Delivery and Induced Labor Indications

目的:探讨产后妇康方辨证加减联合延长放置宫颈扩张球囊对阴道分娩引产指征孕妇预后的影响。方法:选择2013年7月—2015年7月医院阴道分娩指征的产妇210例作为研究对象,均延长COOK宫颈扩张球囊达16 h左右,采用随机数字表法将患者分为观察组和对照组,各105例。对照组产后服用红糖水,观察组在对照组基础上给予妇康方辨证加减,两组均连续服用7 d。记录产妇产后泌乳始动时间、产后7 d泌乳、产后7 d母乳喂养率及子宫复旧情况,测定纤维蛋白原(FIB)、D-二聚体(D-D)水平。结果:观察组<24 h泌乳率为58.10%高于对照组的26.67%,>48 h泌乳率为4.76%低于对照组的24.76%(P<0.05);观察组产后泌乳充足率和产后7 d纯母乳喂养率分别为76.19%、84.76%高于对照组的58.10%、72.38%(P<0.05);观察组产后7d子宫底高度高于对照组,阴道恶露量少于对照组,恶露时间短于对照组(P<0.05);观察组产后7 d D-D水平低于对照组(P<0.05)。结论:阴道分娩引产指征孕妇予以延长放置宫颈扩张球囊引产后,给予妇康方辨证加减治疗,可降低D-D水平,缩短产后泌乳时间,促使子宫复旧。

Objective： To explore the effect of postpartum Modified Fukang Decoction combined with prolonged in- dwelling of cervical dilatation balloon on the prognosis of pregnant women with vaginal delivery and induced labor indica- tions. Methods ： A total of 210 pregnant women with vaginal delivery and induced labor indications who were admitted in our hospital between July 2013 and July 2015 were selected as study subjects. The time of COOK cervical dilation balloon was prolonged to about 16 hours. By the random number table method, the patients were divided into observation group and control group, 105 cases in each. The control group took brown sugar water after delivery while the observation group, based on the control group, was treated with Modified Fukang Decoction. Both of the two groups were continuously treated for 7d. The postpartum initial time of lactation, postpartum 7d lactation, postpartum 7d breastfeeding rate and sta- tus of uterine involution were recorded. The levels of fibrinogen （ FIB ） and D - Dimer （ D - D ） were determined. Re- sults： The 〈 24h lactation rate in observation group （58.10%） was higher than the control group＇ s （26.67%） while 〉 48h lactation rate （4.76%） was lower than the control group＇s （P 〈 0. 05）. The postpartum lactation adequacy ratio and postpartum 7d pure breast - feeding rate in observation group （76. 19% , 84.76% ） were higher than the control group＇ s （58.10% , 72.38% ） （P 〈 0. 05 ）. At postpartum 7d, uterine fundus height of observation group was higher than the control group＇ s and vaginal lochia volume was less than that of the control group and lochia time was shorter than that of the control group （P 〈 0. 05 ）. At postpartum 7d, D - D level in observation group was lower than that of the con- trol group （ P 〈 0. 05 ）. Conclusion ： After vaginal prolonged indwelling of cervical dilatation balloon induced labor, the application of Modified Fukang Decoction in pregnant women with vaginal delivery and induced labor indications can re- duce D - D level, shorten the time of postpartum lactation and promote uterine involution.