罗沛芬++曾带娣++李仲均

[摘要]目的 探討宫颈扩张球囊配合缩宫素在足月妊娠引产中的临床效果。方法 将2015年6月～2016年12月在我院接受治疗的100例具有引产指征的足月妊娠产妇按照随机数字表法分为两组，对照组50例产妇采用缩宫素引产，研究组50例产妇给予宫颈扩张球囊配合缩宫素引产。比较两组产妇引产情况、分娩情况、产程情况、新生儿情况以及并发症发生情况。结果 研究组促进宫颈成熟率（100.00%）显著高于对照组（68.00%）（P<0.05）。干预前两组产妇宫颈Bishop评分比较差异无统计学意义（P>0.05），干预后研究组产妇宫颈Bishop评分显著高于对照组（P<0.05）。研究组诱发临产时间显著短于对照组，且引产成功率高于对照组，剖宫产率低于对照组（P<0.05）。研究组第一产程及总产程时间显著短于对照组（P<0.05），两组第二产程时间比较差异无统计学意义（P>0.05）。两组新生儿情况比较差异无统计学意义（P>0.05）。两组间盆腔感染、产后出血、宫颈裂伤、羊水Ⅱ度以上并发症发生率比较，差异无统计学意义（P>0.05），研究组羊水污染发生率显著高于对照组（P<0.05）。结论 在具有引产指征的足月妊娠产妇引产中选择宫颈扩张球囊配合缩宫素可促进宫颈成熟，缩短产程，提高引产成功率，降低剖宫产率，安全有效，值得在临床上推广使用。

[关键词]足月妊娠；引产；宫颈扩张球囊；缩宫素

[中图分类号] R719.31 [文献标识码] A [文章编号] 1674-4721（2017）09（a）-0100-04

Effect of cervical dilation balloon with oxytocin on induced labor in full-term pregnancy

LUO Pei-fen ZENG Dai-di LI Zhong-jun

Department of Obstetrics and Gynecology，Dongguan People′s Hospital，Guangdong Province，Dongguan 523000，China

[Abstract]Objective To explore the clinical effect of cervical dilatation balloon combined with oxytocin on induction of labor in full-term pregnancy.Methods From June 2015 to December 2016，100 full-term pregnant women with induced labor indications were evenly divided into two groups according to a random number table.Oxytocin was use in 50 pregnant women of the control group for labor induction，while in study group，cervical dilatation balloon combined with oxytocin was used in 50 pregnant women for induction.The induced labor，delivery，labor of stage，neonatal conditions，and complications were compared between the two groups.Results In the study group，the promoted cervical ripening rate was 100.00%，significantly higher than that in the control group accounting for 68.00% （P<0.05）.There was no significant difference in Bishop score between the two groups before intervention （P>0.05）.The Bishop score of the cervix in the study group was significantly higher than that in the control group after intervention （P<0.05）.The time of induced labor in the study group was much shorter than that in the control group with a high success rate of induction and low rate of cesarean section （P<0.05）.The time of first stage of labor and total stage of labor in the study group were much shorter compared with those in the control group （P<0.05）.There was no significant difference in the second stage of labor （P>0.05）.There was no significant difference in the neonatal conditions between the two groups （P>0.05）.The complications including pelvic infection，postpartum hemorrhage，cervical laceration，and amniotic fluid in degree Ⅱ were not displayed statistical differences in the two groups （P>0.05）.The incidence of amniotic fluid contamination in the study group was higher than that in the control group （P<0.05）.Conclusion For full-term pregnancy induction with indications，application of cervical dilation balloon with oxytocin can facilitate cervical ripening，shorten the labor stage，increase the success rate of induced labor，and decrease the rate of cesarean section，which is safe and effective，and is worthy of promotion in clinic.endprint

[Key words]Full-term pregnancy；Induced labor；Cervical dilatation balloon；Oxytocin

对足月妊娠未自然临产而且具备引产指征的孕妇，必须给予及时的引产处理。但引产的先决条件为宫颈的成熟度，Bishop评分为临床上对宫颈条件评价的依据，≤3分表示人工破膜失败，应采用其他的方法分娩；4～6分提示试产成功率可达到50%，可进行促宫颈成熟；7～9分试产成功率为80%，>9分者试产均可成功。临床实践中多数孕妇宫颈条件较不满意，需要引产干预。我国临床引产手段长期以来以药物引产为主，但药物在临床应用中有一定的禁忌证和副作用，应用具有局限性[2]。随着医疗水平的发展，为解决引产失败率较高的问题，逐渐将物理方式应用于临床引产中。研究表明，……