宫颈球囊在瘢痕子宫再次妊娠促宫颈成熟中的临床效果

The clinical effects of cervical balloon in the treatment of cervical pregnancy with scar uterus

目的探讨宫颈球囊用于瘢痕子宫再次妊娠促宫颈成熟的临床应用安全性。方法 2013年7月~2016年6月选择在邢台市人民医院进行瘢痕子宫再次妊娠孕妇118例,根据随机信封抽签原则分为观察组与对照组,各59例。照组给予缩宫素针治疗,观察组给予宫颈球囊治疗,对记录两组应用的有效性与安全性。结果观察组与对照组孕妇的年龄、孕龄、体重指数、羊水指数、宫颈Bishop评分等对比差异无统计学意义(P>0.05)。观察组与对照组孕妇的总有效率分别为98.3%和88.1%,观察组高于对照组,差异有统计学意义(P<0.05)。观察组的新生儿体重与1 min新生儿Apagr评分分别为(3278.42±342.91)g和(9.23±0.28)分,对照组分别为(3231.40±401.49)g和(9.18±0.41)分,两组比较差异无统计学意义(P>0.05)。观察组孕妇的第一、第二产程时间短于对照组,差异有统计学意义(P<0.05),自然分娩率高于对照组,差异有统计学意义(P<0.05);同时观察组的羊水污染、软产道裂伤、产褥感染、产后出血等并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论相对于缩宫素,宫颈球囊用于瘢痕子宫再次妊娠能更加有效发挥促宫颈成熟作用,对新生儿无明显负面影响,能缩短产程,提高自然分娩率,减少引产并发症的发生,值得进一步推广。

Objective To investigate the clinical effects of cervical balloon in the treatment of cervical pregnancy with scar uterus. Methods From July 2013 to June 2016, 118 pregnant women with uterine scar pregnancy were selected in Xingtai People′s Hospital and were equally divided into observation group and the control group accorded to the random envelope drawing principle, 59 women in each group. The observation group was given cervical balloon treatment, the control group was given oxytocin treatment, the effectiveness and safety of the two groups were recorded. Results There was no significant difference compared in age, gestational age, body mass index（BMI）, amniotic fluid index and Bishop scores between the two groups（P〈0.05）. The total effective rate of the observation group and the control group was 98.3%and 88.1%, respectively, the total effective rate of the observation group was significantly higher than that of the control group, and the differences were significantly（P〈0.05）. The neonatal weight and 1 min Apagr score in the observation group were（3278.42±342.91） g and（9.23±0.28） points, respectively, and the control group were（3231.40±401.49） g and（9.18±0.41） points, had no statistically significant difference between the two groups（P〈0.05）. The first and second stage of labor times in the observation group were significantly shorten than the control group, and the differences were statistically significant（P〈0.05）; the natural childbirth rate in the observation group was significantly higher than the control group, and the differences were statistically significant（P〈0.05）; while the postpartum hemorrhage, puerperal infection,soft birth canal laceration, amniotic fluid contamination and other complications in the observation group were significantly lower than those of the control group, and the differences were statistically significant（P〈0.05）. Conclusion Compared with oxytocin, cervical balloon for uterine scar pregnancy can play more effective role in promoting cervical ripening, it has no significant adverse effects on the newborn, it can shorten the production process, improve the rate of natural childbirth, reduce abortion complications, so it is worthy of further promotion.