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目的:观察宫颈扩张球囊用于妊娠晚期促宫颈成熟的效果。方法:选择足月且具有引产指征的妊娠妇女180例,随机分为观察组和对照组各90例。对照组常规采用静脉滴注催产素促宫颈成熟;观察组将宫颈扩张球囊置入宫颈管内促宫颈成熟,宫颈内外球囊各注入0.9%氯化钠溶液80 ml,未自行分娩者在12 h后取出球囊,加用催产素静脉滴注,催产素用法和用量同对照组。观察比较两组引产后宫颈Bishop评分、引产成功、剖宫产及胎儿窘迫、新生儿窒息等情况。结果:(1)观察组引产后24 h宫颈Bishop评分(8.03±1.12)分,非常显著高于对照组的(5.15±1.05)分(P<0.01)。观察组引产成功87例,占96.7%;对照组引产成功39例,占43.3%;观察组引产成功率非常显著高于对照组(P<0.01)。观察组剖宫产10例,占11.1%;对照组剖宫产37例,占41.1%;观察组剖宫产率非常显著低于对照组(P<0.01)。(2)观察组发生胎儿窘迫12例、新生儿窒息2例,分别占13.3%和2.2%;对照组发生胎儿窘迫13例、新生儿窒息3例,分别占14.4%和3.3%。两组胎儿窘迫、新生儿窒息发生率比较,均差异不显著(P>0.05)。结论:宫颈扩张球囊用于妊娠晚期促宫颈成熟有效且安全,可显著提高引产成功率,降低剖宫产率。
Objective: To observe the effect of cervical dilatation balloon for cervical ripening in late pregnancy. Methods: One hundred and eighty pregnant women with full-term indications of induction of labor were randomly divided into observation group (n = 90) and control group (n = 90). In the control group, intravenous infusion of oxytocin was used to induce cervical ripening. In the observation group, the cervical dilatation balloon was inserted into the cervical canal to promote the ripening of the cervix. The cervix and cervix were infused with 0.9% sodium chloride solution 80 ml each. After removing the balloon, plus intravenous infusion of oxytocin oxytocin usage and dosage with the control group. The incidence of cervical Bishop after induction of labor, successful induction of labor, cesarean section and fetal distress, neonatal asphyxia were observed and compared between the two groups. Results: (1) The Bishop cervical score (8.03 ± 1.12) at 24 hours after induction of labor in observation group was significantly higher than that of control group (5.15 ± 1.05) (P <0.01). In the observation group, 87 cases were induced successfully, accounting for 96.7%. In the control group, 39 cases were induced successfully, accounting for 43.3%. The success rate of induction of labor in the observation group was significantly higher than that of the control group (P <0.01). Cesarean section in observation group 10 cases, accounting for 11.1%; control group 37 cases of cesarean section, accounting for 41.1%; observation group cesarean section rate was significantly lower than the control group (P <0.01). (2) There were 12 cases of fetal distress and 2 cases of neonatal asphyxia in the observation group, accounting for 13.3% and 2.2% respectively. In the control group, there were 13 cases of fetal distress and 3 cases of neonatal asphyxia, accounting for 14.4% and 3.3% respectively. There was no significant difference between the two groups in fetal distress and neonatal asphyxia (P> 0.05). Conclusion: The cervical dilatation balloon is effective and safe for promoting cervical ripening in late pregnancy, which can significantly improve the success rate of induced labor and reduce the rate of cesarean section.