双腔水囊结合缩宫素对妊娠晚期糖尿病孕妇引产结局的效果研究

Effects of double lumen balloon combined with oxytocin on the outcome of labor induction in diabetes patients in late pregnancy

目的探讨双腔水囊结合缩宫素对妊娠晚期糖尿病引产的临床效果。方法选择计划分娩的妊娠糖尿病孕妇100例。按照随机双盲法分为研究组和对照组,每组50例。研究组用双腔水囊结合催产素治疗,对照组用米索前列醇治疗。对未能引产的患者进行常规剖宫产。收集分娩前询问病史和实验室检查,收集孕妇基本情况,引产前后宫颈Bishop评分,比较2组孕妇总产程时间、并发症发生率、一次引产成功率、产后出血量、新生儿窒息率、产后血糖和产后尿潴留的发生率。结果2组产后均无严重不良反应,2组均可以促进宫颈成熟,但研究组引产成功率高于对照组,对照组孕妇的剖宫产手术比例与对照组相比较高,2组分娩结局差异有统计学意义(P<0.05)。研究组总产程时间、出血量、产后新生儿窒息率、孕妇的并发症发生率较对照组低,差异均有统计学意义(P<0.05)。结论对于晚期妊娠糖尿病,双腔水囊操作简单方便,无药物毒副反应,不良反应不明显,结合催产素可以提高引产成功率,减少产后出血,缩短分娩过程,改善阴道分娩率,降低剖宫产率,并减少新生儿窒息率,可更好适用于临床。

Objective To investigate the effects of double lumen balloon combined with oxytocin on the outcome of labor induction in diabetes patients in late pregnancy.Methods A total of 100 pregnant women with gestational diabetes who were to give birth in our hospital were randomly divided into control group and research group,with 50 cases in each group.The patients in both groups were treated by misoprostol and double lumen balloon combined with oxytocin,respectively.The patients who failed to induce labor underwent routine cesarean section.The disease history,laboratory examinations before delivery,basic information and cervical Bishop scores before and after labor induction of the women were collected.The total labor time,incidence of complication,successful abortion rate,postpartum hemorrhage,neonatal asphyxia rate,incidence of postpartum blood glucose and postpartum urinary retention were compared between the two groups.Results No serious adverse reactions after delivery were found in both groups.Both misoprostol and double lumen balloon combined with oxytocin could promote cervical ripening.There was significant difference in delivery outcomes between the two groups(P<0.05).Moreover,the success rate in study group was higher than that in control group.The total labor time,the amount of postpartum hemorrhage,the rate of neonatal asphyxia and the incidence of complication in study group were lower than those in control group(P<0.05).In addition,the proportion of cesarean section surgery in study group was higher than that in control group.Conclusion The double lumen balloon combined with oxytocin can improve the success rate of labor induction,reduce postpartum hemorrhage,shorten the delivery process,improve the vaginal delivery rate,reduce the rate of cesarean section and the rate of neonatal asphyxia,which is worthy of clinical promotion.