沈霞 董娟利 耿茂林 黄艳卉

[摘要] 目的 分析Cook球囊联合缩宫素用于足月引产的效果。 方法 选取2020年6—12月我院80例足月妊娠孕妇，以引产方案差异性分为对照组和研究组，每组各40例。对照组采用缩宫素治疗，研究组采用Cook球囊联合缩宫素治疗。比较两组宫颈成熟度、用药后临产发动时间及总产程、产后出血量、不良反应发生率、剖宫产率和新生儿Apgar评分。 结果 研究组促宫颈成熟总有效率为97.50%，较对照组的85.00%更高（P<0.05）;研究组用药后临产发动时间、总产程均较对照组更短，且产后出血量较对照组更少（P<0.05）;研究组胃肠道不适、宫缩过强以及胎心异常等不良反应总发生率为2.50%，较对照组的15.00%更低（P<0.05）;研究组剖宫产率低于对照组（P<0.05），两组新生儿Apgar评分比较，差异无统计学意义（P>0.05），但研究组略高。 结论 在足月引产产妇中采取Cook球囊联合缩宫素方案，与单纯使用缩宫素比较，整体效果更佳，主要表现在促宫颈成熟总有效率高，用药后临产发动时间、总产程时间短，产后出血量少，不良反应发生率低，剖宫产率低。

[关键词] 足月引产;Cook球囊;缩宫素;不良反应

[中图分类号] R719.3          [文献标识码] B          [文章编号] 1673-9701（2021）34-0060-03

[Abstract] Objective To analyze the effect of Cook balloon combined with oxytocin on full-term induced labor. Methods Eighty full-term pregnant women from June to December 2020 were selected and divided into the control group （oxytocin， n=40） and the study group （Cook balloon combined with oxytocin，n=40），according to the difference of induction protocol. Cervical maturity， onset time of labor after treatment， total labor and postpartum hemorrhage， the incidence rate of adverse reactions，cesarean section rate，and neonatal Apgar score were compared. Results The total effective rate of cervical ripening in the study group was 97.50%，which was higher than that of 85.00% in the control group （P<0.05）. The onset time of labor and total labor course after treatment in the study group were shorter than those in the control group， and the postpartum hemorrhage was less than that in the control group（P<0.05）. The incidence rate of gastrointestinal discomfort， excessive uterine contraction， and abnormal fetal heart rate  in the study group was 2.50%，which was lower than that of 15.00% in the control group （P<0.05）. The cesarean section rate in the study group was lower than that in the control group （P<0.05）. There was no difference in Apgar score between the two groups （P>0.05）， but the Apgar score in the study group was slightly higher. Conclusion Cook balloon combined with oxytocin regimen has a better overall effect than oxytocin alone in full-term induced labor， mainly manifested in the high total effective rate of cervical ripening， short onset time of labor and total labor time after medication， less postpartum hemorrhage， low incidence of adverse reactions and low cesarean section rate.

[Key words] Full-term induced labor; Cook balloon; Oxytocin; Adverse effect

足月引產指在自然临产前通过药物等方式使产程发动，进而达到分娩目的，是产科处理高危妊娠的重要手段[1]。在足月引产过程中，宫颈成熟度是决定引产能否成功的关键所在，如果宫颈成熟度不佳进行引产，阴道分娩失败风险较高，因此，提高促宫颈成熟效果是保证顺利引产的重中之重[2]。目前，临床进行足月引产的方法主要有物理方式、药物方式两种，其中，单纯采取药物促进宫颈成熟在临床足月引产中应用广泛且能够取得良好效果。但是，有研究证实，联合球囊技术能够进一步提高引产效果、安全性，应用效果和价值更高[3]。为此，本研究抽取2020年6—12月我院80例足月妊娠孕妇，对不同引产方案效果进行比较分析，旨在为临床足月引产提供参考，提升产妇临床受益，现报道如下。……