双球囊导管在促宫颈成熟中的应用效果及安全性

目的：探讨采用双球囊导管在足月初产妇促宫颈成熟中的临床效果、安全性及对产程的影响作用。方法选取2013至2014年在南京医科大学附属淮安市第一人民医院产科采用促宫颈成熟法分娩的孕妇217例，采取随机数字表法将217例患者分为双球囊组（双球囊导管）108例和缩宫素组（给予小剂量缩宫素）109例，比较两组促宫颈成熟的有效性、安全性及产程差异。结果双球囊组促宫颈成熟的总有效率为98．15％，缩宫素组的总有效率为96．33％，两组无显著性差异（χ2＝0．67，P＞0．05），双球囊组的剖宫产率为23．15％，显著的低于缩宫素组的39．45％（χ2＝6．70，P＜0．05）；两组间子宫强直收缩、新生儿窒息、产妇尿潴留均无显著性差异（χ2值分别为0．10、0．10和0．67，均P＞0．05），且产后2h出血量无显著性差异（t＝1．58，P＞0．05）。双球囊组第一产程潜伏期显著短于缩宫素组（t＝16．23，P＜0．05），双球囊组的第一产程活跃期显著长于缩宫素组（t＝6．32，P＜0．05）；两组间第二产程、第三产程比较差异均有显著性（t值分别为0．45和1．63，均P＜0．05）。结论双球囊导管在足月初产妇促宫颈成熟中具有显著效果，同时具有缩短第一产程潜伏期的作用。

Application effect and safety of double balloon catheter in promoting cervical ripening

Objective To investigate the clinical effect and safety of double balloon catheter in promoting cervical ripening of full -term primipara and its effects on production process .Methods From 2013 to 2014 totally 217 pregnant women giving birth in Huai ’ an First People’s Hospital using cervical ripening method were selected and divided into double balloon group (108 cases, double balloon catheter) and oxytocin group (109 cases, low dosage of oxytocin ) with random number table method .Two groups were compared in efficacy and safety of cervical ripening as well as birth process .Results The total efficiency of promoting cervical ripening was 98.15%and 96.33%in double balloon group and oxytocin group , respectively, and the difference was not significant (χ2 =0.67,P>0.05).In double balloon group cesarean section rate was 23.15%, which was significantly lower than that in oxytocin group (39.45%) (χ2 =6.70, P<0.05). Two groups were not remarkably different in uterine tonic contraction , neonatal asphyxia and maternal urinary retention (χ2 value was 0.10, 0.10 and 0.67, respectively, all P>0.05), and there was no significant difference in the amount of bleeding 2h after delivery (t=1.58, P>0.05).The latency period of the first stage of double balloon group was significantly shorter than that of oxytocin group (t=16.23, P<0.05), but the active period of the first stage was significantly longer (t=6.32, P<0.05).The differences between two groups in the second and the third stage of labor were significant (t value was 0.45 and 1.63, respectively, both P<0.05).Conclusion Double balloon catheter has significant effect in promoting cervical ripening in full-term primipara, and it can shorten the incubation period of the first stage of labor as well .