相同容量的宫颈扩张单腔球囊与COOK宫颈扩张双腔球囊在足月妊娠引产中的临床疗效比较

发布时间：2018-06-19 13:26

本文选题：单腔球囊 + 双腔球囊　；参考：《苏州大学》2016年硕士论文

【摘要】：目的:本论文通过比较160ml单、双球囊引产用于足月妊娠促宫颈成熟的临床效果,探讨相同容量单、双腔球囊引产在产科实际应用中的优缺点,为提高临床足月妊娠促宫颈成熟效果提供证据及经验。方法:对收集的符合引产指征、宫颈Bishop评分6分、单胎头位孕足月的160例初产妇进行引产效果分析。160例孕妇分成两组:研究组:80例采用宫颈扩张单腔球囊引产.对照组:80例采用Cook宫颈扩张双腔球囊引产。观察两组受试者妊娠合并症、宫颈Bishop评分、围生儿结局、引产过程、引产结局以及不良事件发生率。本研究征得受试对象知情同意,并与之签署临床研究知情同意书。结果:1.研究组与对照组两组患者在年龄(岁)、孕次(次)、产次(次)、分娩孕龄(周)以及孕妇体质量指数(kg/m2)等基本资料之间差异不显著(P0.05),无统计学意义。2.研究组与对照组两组患者在妊娠期糖尿病例数以及妊娠期高血压疾病例数之间差异不显著(P0.05),无统计学意义;研究组与对照组两组患者在羊水偏少例数之间差异显著(P0.05),有统计学意义。3.治疗前研究组与对照组促宫颈成熟比较无显著差异(P0.05),无统计学意义。治疗后研究组与对照组促宫颈成熟比较差异显著(P0.05),有统计学意义;研究组球囊作用时间明显短于对照组(P0.05),有统计学意义;研究组促宫颈成熟有效率显著高于对照组(P0.05),有统计学意义。研究组球囊脱落率明显高于对照组(P0.05),有统计学意义。4.研究组与对照组两组患者在新生儿出生体质量(g)、身长(cm)、新生儿窒息例数[n(%)]以及胎儿窘迫例数[n(%)]这些围生儿结局情况之间差异不显著(P0.05),无统计学意义。5.研究组与对照组两组患者在感染等并发症之间差异不显著(P0.05),无统计学意义;在产后出血、脐带脱垂并发症方面差异显著(P0.05),有统计学意义。6.研究组与对照组两组患者在引产成功率、剖宫产率之间差异不显著(P0.05),无统计学意义;研究组与对照组两组在临产时间、第一产程、潜伏期产程方面差异显著(P0.05),有统计学意义。在活跃期以及第二产程差异不显著(P0.05),无统计学意义。7.研究组与对照组改行剖宫产总例数差异不显著(P0.05),无统计学意义。研究组中由于社会因素、脐带脱垂改行剖宫产的例数显著高于对照组(P0.05),有统计学意义。研究组中由于产程异常改行剖宫产的例数显著低于对照组(P0.05),有统计学意义。研究组中由于胎儿窘迫改行剖宫产的例数与对照组无显著差异(P0.05),无统计学意义。结论:相同容量的单双腔球囊在足月妊娠引产中各有利弊,临床工作应具体情况具体分析,以提高产科质量,减少不良事件的发生。
[Abstract]:Objective: to compare the clinical effect of 160ml single and double balloon induced labor in term pregnancy and to explore the advantages and disadvantages of the same volume single and double chamber balloon induction in obstetrics. To improve the clinical term pregnancy to promote cervical maturation effect to provide evidence and experience. Methods: according to the indication of induced labor, the cervical Bishop score was 6 points and 160 primiparas with single fetal head position were analyzed. 160 pregnant women were divided into two groups: study group: 80 cases were induced labor by cervical dilatation single chamber balloon. 80 cases of control group were treated with Cook's dilated double chamber balloon to induce labor. The complications of pregnancy, cervical Bishop score, perinatal outcome, induced labor process, induced labor outcome and incidence of adverse events were observed. This study obtained the informed consent of the subjects and signed the informed consent of clinical research. The result is 1: 1. There was no significant difference between the study group and the control group in the basic data of age (age), pregnancy time (secondary age, birth age (week) and pregnant women's body mass index (BMI) (P 0.05), and there was no significant difference between the two groups (P 0.05, P < 0.05), and there was no significant difference between the two groups (P > 0.05), and there was no significant difference between the two groups. There was no significant difference in the number of gestational diabetes mellitus and hypertensive disorder complicating pregnancy between the study group and the control group (P 0.05). The difference between the two groups in the number of oligohydramnios was significant (P 0.05), which was statistically significant. There was no significant difference in cervical maturation between the study group and the control group before treatment (P 0.05). After treatment, there was significant difference in promoting cervical maturation between the study group and the control group (P 0.05), and the time of balloon action in the study group was significantly shorter than that in the control group (P 0.05). The effective rate of cervical maturation in the study group was significantly higher than that in the control group (P 0.05). The balloon abscission rate in the study group was significantly higher than that in the control group (P 0.05), with statistical significance. 4. There was no significant difference in the perinatal outcomes between the study group and the control group in terms of birth weight, body length, neonatal asphyxia and fetal distress (P 0.05, P 0.05, P < 0.05). There was no significant difference between the study group and the control group in infection and other complications, there was no significant difference in postpartum hemorrhage, umbilical cord prolapse complications, there was significant difference between the two groups. There was no significant difference in the success rate of induced labor and the rate of cesarean section between the study group and the control group (P 0.05), and there was significant difference between the study group and the control group in the time of labor, the first stage of labor and the stage of labor latency (P 0.05). There was no significant difference between the active stage and the second stage of labor (P 0.05), and there was no statistical significance. There was no significant difference in total cases of cesarean section between the study group and the control group (P 0.05). Because of social factors, the number of cases of umbilical cord prolapse converted to cesarean section in the study group was significantly higher than that in the control group (P 0.05). In the study group, the number of patients undergoing cesarean section due to abnormal labor was significantly lower than that of the control group (P 0.05). There was no significant difference in the number of caesarean section cases between the study group and the control group (P 0.05). Conclusion: the single and double chamber balloon of the same volume has its advantages and disadvantages in the induction of labor during term pregnancy. The clinical work should be analyzed in order to improve the quality of obstetrics and reduce the occurrence of adverse events.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R719.3

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