盐酸消旋山莨菪碱结合宫颈扩张球囊在瘢痕子宫足月妊娠产妇的引产效果分析

Induction effect of racemic anisodamine hydrochloride combined with cervical dilatation balloon in full⁃term pregnant women with scarred uterus

目的探讨盐酸消旋山莨菪碱结合宫颈扩张球囊在瘢痕子宫足月妊娠产妇的引产效果。方法前瞻性选择2019年1月至2023年2月河池市妇幼保健院收治的106例瘢痕子宫足月妊娠产妇作为研究对象,经随机数字表法分为研究组和对照组各53例。对照组给予盐酸消旋山莨菪碱治疗,研究组在对照组的基础上给予宫颈扩张球囊联合治疗。比较两组促宫颈成熟疗效、引产效果、手术相关指标、母婴结局、并发症的不同情况。结果研究组促宫颈成熟总有效率、引产成功率高于对照组,差异有统计学意义(P<0.05);研究组诱发规律宫缩时间、宫口开全时间、总产程时间均短于对照组,产后2 h出血量少于对照组,差异有统计学意义(P<0.05);研究组胎儿窘迫率、新生儿窒息率、剖宫产率、产后出血率均低于对照组,新生儿Apgar评分、阴道分娩率高于对照组,差异有统计学意义(P<0.05);两组新生儿体重与并发症发生率比较差异无统计学意义(P>0.05)。结论盐酸消旋山莨菪碱结合宫颈扩张球囊可促进瘢痕子宫足月妊娠产妇宫颈成熟,快速诱发宫缩,提高引产成功率和阴道分娩率,改善母婴结局,且安全性较好。

Objective To investigate the induction effect of racemic anisodamine hydrochloride combined with cervical dilatation balloon in full-term pregnant women with scarred uterus.Methods A total of 106 full⁃term pregnant women with scarred uterus admitted to Hechi Maternal and Child Health Hospital from January 2019 to February 2023 were prospectively selected and grouped by random number table method,with 53 cases in the study group and 53 cases in the control group.The control group was treated with racemic anisodamine hydrochloride,and the study group received cervical dilation balloon combined treatment on the basis of the control group.The effects of cervical maturation promotion,labor induction,surgical indicators,maternal and infant outcomes,complications were compared between the two groups.Results The total effective rate of cervical maturation promotion,the success rate of labor induction in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).The induced regular contractions time,total uterine opening time and total labor time in the study group were shorter,postpartum 2 h blood loss was less than that of control group,and the difference was statisicant(P<0.05).The rates of fetal distress,neonatal asphyxia,cesarean section and postpartum hemorrhage in the study group were lower than those in the control group,Apgar score and the vaginal delivery rate was higher than that of the control group(P<0.05).There was no significant difference in body mass and the complication rate between the two groups(P>0.05).Conclusion Racemic anisodamine hydrochloride combined with cervical dilatation balloon can promote cervical maturity in full⁃term pregnant women with scarred uterus,rapidly induce contractions,improve successful labor induction rate and vaginal delivery rate,and improve maternal and infant outcomes with good safety.