CAJ | 학술논문

目的：：探讨COOK宫颈扩张球囊应用于妊娠晚期单胎孕妇促宫颈成熟及引产的有效性及安全性。方法：收集广州医科大学附属第一医院妇产科2014年1月至2014年12月113例应用COOK宫颈扩张球囊孕妇的临床资料,按照放置球囊前的宫颈Bishop评分分为A组( Bishop 评分≤3分,78例)和B组( Bishop 评分4-5分,35例),并收集同期直接使用小剂量缩宫素静滴的孕妇设为C组( Bishop评分4~5分,35例),分别比较3组资料中宫颈Bishop评分、引产成功率、分娩情况及对母婴结局的影响。结果：3组资料中2种方法均能在不同程度上达到促宫颈成熟的目的,其中, A、B两组使用COOK宫颈扩张球囊促宫颈成熟有效率均显著高于C组,差异有统计学意义( P<0.05)。 A、B两组第一产程时间显著少于C组、引产成功率显著高于C组、剖宫产率显著低于C组,差异均有统计学意义( P<0.05)。 A组与B组促宫颈成熟有效率( A组92.31％、B组100％)、阴道分娩率( A组82.05％、B组85.71％)随宫颈初始评分逐渐递增,即宫颈初始评分越高,促宫颈成熟有效率及引产率越高,差异有统计学意义( P<0.05)。3组对母婴结局中产后出血、新生儿评分的比较差异无统计学意义(均P>0.05)。结论：COOK宫颈扩张球囊应用于妊娠晚期单胎孕妇促宫颈成熟及引产有效、安全,可有效提高引产成功率,降低剖宫产率,值得临床推广应用。
목적：：탐토COOK궁경확장구낭응용우임신만기단태잉부촉궁경성숙급인산적유효성급안전성。방법：수집엄주의과대학부속제일의원부산과2014년1월지2014년12월113례응용COOK궁경확장구낭잉부적림상자료,안조방치구낭전적궁경Bishop평분분위A조( Bishop 평분≤3분,78례)화B조( Bishop 평분4-5분,35례),병수집동기직접사용소제량축궁소정적적잉부설위C조( Bishop평분4~5분,35례),분별비교3조자료중궁경Bishop평분、인산성공솔、분면정황급대모영결국적영향。결과：3조자료중2충방법균능재불동정도상체도촉궁경성숙적목적,기중, A、B량조사용COOK궁경확장구낭촉궁경성숙유효솔균현저고우C조,차이유통계학의의( P<0.05)。 A、B량조제일산정시간현저소우C조、인산성공솔현저고우C조、부궁산솔현저저우C조,차이균유통계학의의( P<0.05)。 A조여B조촉궁경성숙유효솔( A조92.31％、B조100％)、음도분면솔( A조82.05％、B조85.71％)수궁경초시평분축점체증,즉궁경초시평분월고,촉궁경성숙유효솔급인산솔월고,차이유통계학의의( P<0.05)。3조대모영결국중산후출혈、신생인평분적비교차이무통계학의의(균P>0.05)。결론：COOK궁경확장구낭응용우임신만기단태잉부촉궁경성숙급인산유효、안전,가유효제고인산성공솔,강저부궁산솔,치득림상추엄응용。
Objective:To investigate the effectiveness and safety of COOK cervical ripening balloon used in the third trimester pregnant women to promote cervical mature and induce labor. Method:From January 2014 to December 2014, 113 subjects receiving placement of COOK cervical ripening balloon at the Department of Obstetrics and Gynecology, the First Affiliated Hospital of Guangzhou Medical College were studied. According to the cervical Bishop score before placing the balloon, the patients were divided into group A ( Bishop score ≤3, 78 cases) and group B (Bishop score: 4-5, 35 cases), and subjects receiving low dose intravenous oxytocin during the same period directly were set as group C ( Bishop score: 4-5, 35 cases ) . The effects of cervical Bishop score, success rate of induced labor, and delivery conditions on maternal-infant outcome were compared in the three sets of data. Result: The two methods applied in the three groups can both achieve the purpose of enhancing cervical ripening in varying degrees. The effectiveness of group A and B ( using COOK cervical ripening balloon) in promoting cervical mature is significantly higher than that of group C( P<0.05) . The duration of the first stage of labor in group A, B is significantly shorter than group C, the induced labor rate of group A, B is significantly higher than group C, and the cesarean delivery rate of group A, B is significantly lower than that of group C, the differences are all statistically significant(P<0.05). Therefore, compared with low dose intravenous oxytocin, COOK cervical ripening balloon can be more effective in promoting cervical mature and improving the rate of induced labor. As the initial Bishop? score increases, the efficacy in enhancing cervical ripening ( group A, 92.31%、group B, 100%) , and rate of vaginal delivery ( group A, 82. 05%、group B, 85. 71%) rise gradually, that is, the higher initial Bishop? score indicates more effective cervical ripening and higher vaginal delivery rate, the differences are of statistical significance( P<0.05) . There are no significant differences in postpartum hemorrhage and neonatal score among the three groups( all P>0.05) . Conclusion:COOK cervical ripening balloon used in third trimester pregnant women can effectively and safely promote cervical mature and induce labor, further improve the success rate of induced labor, reduce the cesarean delivery rate, and should be adapted for more widespread clinical use.