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目的比较COOK子宫颈扩张球囊和一次性宫颈扩张球囊与缩宫素促宫颈成熟的效果。方法选取该院2014年5月-2015年10月收治的未临产住院初产妇255例,按照随机数字表法将所有初产妇随机分为缩宫素组、一次性宫颈扩张球囊(单球水囊组)以及COOK子宫颈扩张球囊(COOK球囊组)3组,平均每组产妇85例。对所有入选初产妇均给予促宫颈成熟治疗,观察比较3组产妇的促宫颈成熟的效果、第一产程时间、放置球囊后的疼痛时间、放置球囊后至取出前阴道的出血量以及自然分娩率、剖宫产率等。结果放置球囊前,3组产妇的宫颈评分比较差异均无统计学意义(t=0.325、0.184、0.742,P>0.05);放置球囊后,缩宫素组产妇的宫颈评分显著低于单球水囊组和COOK球囊组产妇,差异有统计学意义(t=11.752、13.979,P<0.05),单球水囊组产妇的宫颈评分显著低于COOK球囊组产妇,差异有统计学意义(t=2.581,P<0.05);单球水囊组产妇和COOK球囊组产妇促宫颈成熟成功率均显著高于缩宫素组,差异有统计学意义(χ2=115.431、124.283,P<0.05);单球水囊组产妇和缩宫素组产妇的第一产程时间均显著长于COOK球囊组产妇,差异有统计学意义(t=2.410、11.028,P<0.05),缩宫素组产妇的第一产程时间又明显长于单球水囊组产妇,差异有统计学意义(t=8.283,P<0.05)。COOK球囊组产妇的阴道流血量和疼痛时间均显著低于单球水囊组产妇,差异有统计学意义(t=6.524、10.028,P<0.05)。单球水囊组产妇和COOK球囊组产妇的剖宫产率均显著低于缩宫素组产妇,差异有统计学意义(χ2=7.273、10.242,P<0.05)。结论一次性宫颈扩张球囊和COOK子宫颈扩张球囊对初产妇促宫颈成熟、提高初产妇阴道分娩率和缩短产程都有较好的临床效果,其中COOK子宫颈扩张球囊在减少产妇不适感以及促宫颈成熟方面的效果更优于一次性宫颈扩张球囊。
Objective To compare the effect of COOK cervical dilatation balloon and disposable cervical dilatation balloon and oxytocin to promote cervical ripening. Methods 255 cases of primipara from non-labor hospitalized from May 2014 to October 2015 in our hospital were randomly divided into oxytocin group, single-use cervical dilatation balloon Capsule group) and COOK cervical dilatation balloon (COOK balloon group) 3 groups, with an average of 85 cases per group of maternal. All selected primipara were given cervical maturation treatment, observed and compared the effect of three groups of maternal cervical maturation, the first stage of labor time, the pain after placing the balloon, the amount of bleeding after the balloon was placed to remove the vaginal bleeding and natural Childbirth rate, cesarean section rate and so on. Results There were no significant differences in cervical scores between the three groups before placement of the balloon (t = 0.325,0.184,0.742, P> 0.05). After placing the balloon, the cervical score of the oxytocin group was significantly lower than that of the single Balloon group and COOK balloon group, the difference was statistically significant (t = 11.752, 13.979, P <0.05). The cervical score of single balloon group was significantly lower than that of COOK balloon group, the difference was statistically significant (Χ2 = 115.431, 124.283, P <0.05). The successful rate of maternal cervical ripening in single balloon group and COOK balloon group was significantly higher than that of oxytocin group (χ2 = 115.431, 124.283, P <0.05). The time of the first stage of labor in maternal and oxytocin groups was significantly longer than that in COOK balloon group (t = 2.410, 11.028, P <0.05) The time of the first stage of labor in the group of maternal was significantly longer than that in the single ball of water bag group, the difference was statistically significant (t = 8.283, P <0.05). The vaginal bleeding volume and pain time in COOK balloon group were significantly lower than those in single balloon group (t = 6.524,10.028, P <0.05). The cesarean section rate of the single ball hydrocyclone group and the COOK balloon group was significantly lower than that of the oxytocin group (χ2 = 7.273,10.242, P <0.05). Conclusions Disposable cervical dilatation balloon and COOK cervical dilatation balloon have a good clinical effect on primipara promoting cervical ripening, improving vaginal delivery rate and shortening labor duration of primipara, among which COOK cervical dilatation balloon can reduce maternal discomfort And the effect of promoting cervical ripening is better than disposable cervical dilatation balloon.