不同促宫颈成熟方案对足月妊娠妊娠期糖尿病患者母婴结局及术后恢复的影响

Effect of different cervical ripening regimens on maternal-infant outcomes and postoperative recovery in patients with gestational diabetes mellitus of full-term pregnancy

目的探究不同促宫颈成熟方案对足月妊娠妊娠期糖尿病(GDM)患者母婴结局及术后恢复的影响。方法回顾性分析2016年1月~2018年6月辽宁省大连市妇幼保健院收治的150例GDM患者的临床资料,根据治疗方法分为三组,分别为单球囊组、双球囊组及缩宫素组,每组各50例,单球囊组采用Foly氏导尿管,双球囊组采用COOK球囊,缩宫素组采用缩宫素治疗。比较三组促宫颈成熟临床疗效及母婴结局,并通过记录其术后不良反应评价恢复情况。结果治疗后,双球囊组促宫颈成熟总有效率(96.00%)高于单球囊组(84.00%)及缩宫素组(66.00%),单球囊组的促宫颈成熟总有效率高于缩宫素组,差异有统计学意义(P<0.05);单球囊组剖宫产率(10.00%)低于双球囊组(26.00%),双球囊组剖宫产率(26.00%)低于缩宫素组(46.00%),差异有统计学意义(P<0.05);三组其他母婴结局(产后出血、宫内感染、胎儿窘迫、新生儿窒息)发生率的比较,差异无统计学意义(P>0.05);单球囊组不良反应总发生率(4.00%)与双球囊组(6.00%)比较,差异无统计学意义(P>0.05);单球囊组、双球囊组的不良反应总发生率均低于缩宫素组(20.00%),差异有统计学意义(P<0.05)。结论宫颈扩张球囊技术更利于足月妊娠GDM患者术后恢复,其中单扩张球囊更有利于自然分娩,双球囊组促进宫颈成熟效果更好。

Objective To explore the effect of different cervical ripening regimens on maternal-infant outcomes and postoperative recovery in patients with gestational diabetes mellitus(GDM)of full-term pregnancy.Methods Retrospective analysis was performed on clinical data of 150 GDM patients from January 2016 to June 2018 in Dalian Maternal and Child Health Hospital,and the patients were divided into three groups according to the treatment methods,including single balloon group,double balloon group and Oxytocin group,50 cases in each group.Single balloon group was given Foly catheter,double balloon group was given COOK balloon,and Oxytocin group was given Oxytocin.The clinical efficacy of cervical ripening and maternal-infant outcomes were compared among the three groups,and the recovery was evaluated by recording the postoperative adverse reactions.Results After treatment,the total effective rate of cervical maturation in double balloon group(96.00%)was higher than that in single balloon group(84.00%)and Oxytocin group(66.00%),that in single balloon group was higher than that of Oxytocin group,with statistical significances(P<0.05).The cesarean section rate of single balloon group(10.00%)was lower than that of double balloon group(26.00%),and that of double balloon group(26.00%)was lower than that of Oxytocin group(46.00%),with statistical differences(P<0.05).There was no significant difference in other maternal-infant outcomes incidence rate(postpartum hemorrhage,intrauterine infection,fetal distress and neonatal asphyxia)among the three groups(P>0.05).The total incidence of adverse reactions in single balloon group(4.00%)was not significantly different from that in double balloon group(6.00%)(P>0.05).The total incidence of adverse reactions in single balloon group and double balloon group was lower than that of the Oxytocin group(20.00%),and the differences were statistically significant(P<0.05).Conclusion Cervical dilation balloon technique is more conducive to postoperative recovery of GDM patients with full-term pregnancy,and single dilation balloon is more conducive to natural delivery,and double-balloon group has a better effect of cervical ripening.