子宫颈单球囊和双球囊在瘢痕子宫足月妊娠引产术的临床效果及安全性比较

Comparison of prognosis and safety between single and double balloon cervix in term pregnancy induced by scar uterus

目的比较子宫颈单球囊和双球囊应用于瘢痕子宫足月妊娠引产术的临床效果及安全性。方法前瞻性选取2017年7月至2020年6月滁州市中西医结合医院收治的200例瘢痕子宫足月妊娠产妇作为研究对象,按随机数字表法将产妇分为两组:100例采用单球囊行促宫颈成熟,为单球囊组;另100例采用双球囊行促宫颈成熟,为双球囊组。观察并比较两组产妇促宫颈成熟疗效、诱发有效宫缩时间、第一产程时间、总产程时间、阴道分娩率、剖宫产率、产后出血量、新生儿窒息、产妇满意度以及并发症发生情况。结果双球囊组促宫颈成熟率(94.00%)高于单球囊组(89.00%),但差异无统计学意义(P>0.05)。双球囊组诱发有效宫缩时间[(16.40±2.69)h]长于单球囊组[(14.55±3.31)h],而第一产程时间和总产程时间为(6.17±1.56)、(7.15±1.87)h,短于单球囊组[(7.63±1.94)、(8.71±2.03)h],差异均有统计学意义(P<0.001)。双球囊组剖宫产率和新生儿窒息率为16.00%、6.00%,显著低于单球囊组(35.00%、17.00%),产后出血量为(145.34±30.56)m L,小于单球囊组[(208.97±41.57)m L],差异均有统计学意义(P<0.05)。双球囊组产妇满意度(95.00%)明显高于单球囊组产妇(78.00%),差异有统计学意义(P<0.05)。双球囊组并发症总发生率(20.00%)明显低于单球囊组(37.00%),差异有统计学意义(P<0.05)。结论单球囊和双球囊均能有效促宫颈成熟,而双球囊诱发有效宫缩时间更长、产程时间更短、剖宫产率更低、安全性更高,能更有效降低瘢痕子宫足月妊娠引产术后并发症总发生率,提高产妇满意度,值得临床推广应用。

Objective To compare the clinical effects and safety of single-balloon and double-balloons for uterine scarred uterus inducing labor in term pregnancy.Methods Two hundred cases of full-term pregnant women with scarred uterus admitted to Chuzhou City Hospital of Integrated Traditional Chinese and Western Medicine from July 2017 to June 2020 were prospectively selected as the research objects.The women were divided into two groups according to the random number table method:100 cases were treated with a single ball.Cervical maturation was promoted by sac line,which was a single-balloon group;the other 100 cases with double balloons were used to promote cervical maturation,which was a double-balloon group.The efficacy of cervical ripening in the two groups of women,the time to induce effective contractions,the time of the first stage of labor,the time of total labor,the rate of vaginal delivery,the rate of cesarean section,postpartum hemorrhage,neonatal asphyxia,maternal satisfaction,and the occurrence of complications were observed and compared.Results The rate of cervical ripening in the double-balloon group(94.00%)was higher than that in the single-balloon group(89.00%),but the difference was not statistically significant(P>0.05).The double-balloon group induced effective uterine contractions was(16.40±2.69)h,which was longer than that in the single-balloon group[(14.55±3.31)h],the first stage of labor and the total duration of labor were(6.17±1.56)and(7.15±1.87)h,which were shorter than those in the single balloon group[(7.63±1.94),(8.71±2.03)h],and the differences were statistically significant(P<0.001).The cesarean section rate and neonatal asphyxia rate in the double-balloon group were 16.00%and 6.00%,which were significantly lower than those in the single-balloon group(35.00%,17.00%),the postpartum hemorrhage was(145.34±30.56)mL,which was less than the single-balloon group.In the group[(208.97±41.57)mL],and the differences were statistically significant(P<0.05).The maternal satisfaction of the double-balloon group(95.00%)was significantly higher than that of the single-balloon group(78.00%),and the difference was statistically significant(P<0.05);the total incidence of complications in the double-balloon group(20.00%)was significantly lower than that in the single-balloon group(37.00%),and the difference was statistically significant(P<0.05).Conclusion Both single balloon and double balloon can effectively promote cervical ripening,while double balloon induces longer effective contractions,shorter labor time,lower cesarean section rate,higher safety,and can more effectively reduce scarred uterine feet The total incidence of complications after induction of labor in a month's pregnancy can improve maternal satisfaction,which is worthy of clinical application.