CAJ | 학술논문

目的：探讨双腔气囊导尿管对延期妊娠促宫颈成熟的临床效果。方法随机将孕（产）妇200例分为试验组和对照组各100例。对照组入院后当日即给予低浓度缩宫素2.5 U加生盐水500 ml静滴引产。试验组入院后次日给予常规外阴、阴道、宫颈消毒后宫颈插入双腔气囊导尿管，气囊内注入60 ml生理盐水，置管次日进行宫颈评分，宫颈评分＞7分以上者为有效，没有出现规律宫缩者给予缩宫素同对照组。视宫缩调速，适时行人工破膜；宫口开大3 cm伴有规律宫缩者期待自然分娩。观察两组孕妇宫颈评分、分娩启动时间及分娩总产程、新生儿出生后评分、产后并发症发生率（生殖道感染和宫颈裂伤）。对比两组治疗后的临床效果。结果试验组临床疗效优于对照组，差异有统计学意义（ P＜0.05）。使用12 h试验组的宫颈评分高于对照组，试验组剖宫产率低于对照组（14.00％vs 29.00％），差异有统计学意义（P＜0.05）。试验组在分娩启动时间、分娩总产程短于对照组，差异有统计学意义（P＜0.01），两组在产后并发症发生率（生殖道感染和宫颈裂伤）、新生儿体重、新生儿评分方面比较差异无统计学意义（P＞0.05）。结论双腔气囊导尿管用于延期妊娠促宫颈成熟安全有效，值得推广。
목적：탐토쌍강기낭도뇨관대연기임신촉궁경성숙적림상효과。방법수궤장잉（산）부200례분위시험조화대조조각100례。대조조입원후당일즉급여저농도축궁소2.5 U가생염수500 ml정적인산。시험조입원후차일급여상규외음、음도、궁경소독후궁경삽입쌍강기낭도뇨관，기낭내주입60 ml생리염수，치관차일진행궁경평분，궁경평분＞7분이상자위유효，몰유출현규률궁축자급여축궁소동대조조。시궁축조속，괄시행인공파막；궁구개대3 cm반유규률궁축자기대자연분면。관찰량조잉부궁경평분、분면계동시간급분면총산정、신생인출생후평분、산후병발증발생솔（생식도감염화궁경렬상）。대비량조치료후적림상효과。결과시험조림상료효우우대조조，차이유통계학의의（ P＜0.05）。사용12 h시험조적궁경평분고우대조조，시험조부궁산솔저우대조조（14.00％vs 29.00％），차이유통계학의의（P＜0.05）。시험조재분면계동시간、분면총산정단우대조조，차이유통계학의의（P＜0.01），량조재산후병발증발생솔（생식도감염화궁경렬상）、신생인체중、신생인평분방면비교차이무통계학의의（P＞0.05）。결론쌍강기낭도뇨관용우연기임신촉궁경성숙안전유효，치득추엄。
Objective To investigate the cervical ripening effect of double lumen Foley catheter in obstetri-cal delayed pregnancy.Methods Two hundred pregnant women who had delayed pregnancy were randomly divided into the experimental group(n=100) and the control group(n=100).On the day of admission the control group was given the low concentration of oxytocin(2.5 U in 500 ml normal saline) intravenously for labor induction.On the next day after admission, the experimental group received routine disinfection for vulva, vagina and cervix,then the double lumen Foley catheter was inserted into the cervix.On the next day after catheterization, cervix was examined for cer-vical score, with cervical scores more than seven points or more being defined as effectiveness.For pregrant women with irregularuterine contraction, the low contraction of oxytocin was given( the dose was the same as that in the con-trol group) .The infusing speed was adjusted according to the condition of uterine contraction and the condition that timely artificial rupture was performed; Pregnant women who had cervix dilativn of 3 cm and regular contractions should be expected natural childbirth.Cervical score, the onset time of labor and total delivery labor time, neonatal scoring after birth, postpartum morbidity(reproductive tract infections and cervical laceration)were observed in the two groups, and the clinical effects after treatment were compared between the two groups.Results The effective rate in the experimental group was significantly higher than that in the control group( P<0.05) .The cervical score in the experimental group was significantly higher than that in the control group after catheterization for 12 hours ( P <0.05).The cesarean section rate was significantly lower in the experimental group than that in the control group (14.00%vs 29.00%)(P<0.05).The onset time of labor and the total delivery labor time in the experimental group were significantly shorter than those in the control group(P<0.01).There were no significant differences in the incidence of postpartum( reproductive tract infections and cervical laceration) , birth weight, neonatal scoring be-tween the two groups( P>0.05 ) .Conclusion Application of double lumen Foley catheter for cervical ripening in delay pregnancy is safe and effective.