COOK宫颈双球囊足月妊娠引产效果的影响因素分析
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摘要
目的分析COOK宫颈双球囊在足月妊娠引产效果的影响因素。方法回顾性分析深圳市罗湖区妇幼保健院妇产科2017年1月至2018年3月收治的孕足月使用COOK宫颈扩张球囊引产的337例孕产妇资料,根据引产成功或失败分为研究组(引产成功)和对照组(引产失败),记录两组的病历资料,采用多因素Logistic回归等方法进行研究。结果 337例产妇中,引产成功293例(87.0%)。与引产失败组(44例)比较,引产成功组的宫颈Bishop评分较高,经产妇比例较高,引产指征为延期妊娠的比例较高、妊娠期高血压疾病的比例较低,球囊放置时间延长比例较高,孕周较大(P<0.05)。结论 COOK双球囊可有效促进足月妊娠孕妇的宫颈成熟;宫颈成熟度、产次、引产指征、孕周、球囊放置时间是影响引产效果的重要因素。
Objective To analyze the influencing factors of COOK double balloon in induction of labor in term pregnancy. Methods Retrospective analysis of 337 cases of maternal data from the obstetrics and gynecology department of Luohu District Maternal and Child Health Hospital of Shenzhen City from January 2017 to March 2018 using the COOK cervical dilatation balloon. According to the success or failure of induction of labor, they were divided into the study group(induction of labor) and the control group(induction of labor failure). The general data and induction data of the two groups were recorded. Multivariate Logistic regression was used to study. Results Of the 337 women, 293 were successful in induction of labor, 44 were failed in induction of labor, and the success rate of induction of COOK double balloon was 87 %. Compared with the induction group, the cervical Bishop score was higher in the successful induction group, and the proportion of maternal women was higher. The induction of labor was higher in the proportion of delayed pregnancy. The induction of labor was lower in the proportion of hypertensive disorder in pregnancy. The time extension ratio was higher and the gestational age was larger(P<0.05).Conclusion COOK double balloon can effectively promote the cervical ripening of pregnant women in term pregnancy;cervical maturity, parity, induction of labor, gestational age, balloon placement time is an important factor affecting the induction of labor.
Objective To analyze the influencing factors of COOK double balloon in induction of labor in term pregnancy. Methods Retrospective analysis of 337 cases of maternal data from the obstetrics and gynecology department of Luohu District Maternal and Child Health Hospital of Shenzhen City from January 2017 to March 2018 using the COOK cervical dilatation balloon. According to the success or failure of induction of labor, they were divided into the study group(induction of labor) and the control group(induction of labor failure). The general data and induction data of the two groups were recorded. Multivariate Logistic regression was used to study. Results Of the 337 women, 293 were successful in induction of labor, 44 were failed in induction of labor, and the success rate of induction of COOK double balloon was 87 %. Compared with the induction group, the cervical Bishop score was higher in the successful induction group, and the proportion of maternal women was higher. The induction of labor was higher in the proportion of delayed pregnancy. The induction of labor was lower in the proportion of hypertensive disorder in pregnancy. The time extension ratio was higher and the gestational age was larger(P<0.05).Conclusion COOK double balloon can effectively promote the cervical ripening of pregnant women in term pregnancy;cervical maturity, parity, induction of labor, gestational age, balloon placement time is an important factor affecting the induction of labor.
引文
[1] 杜彧华,张强.COOK宫颈球囊联合缩宫素促宫颈成熟引产的效果分析 [J].中国计划生育和妇产科,2015,7 (5):52-54.
[2] ALFIREVIC Z, KEENEY E, DOWSWELL T, et al.Which method is best for the induction of labour? A systematic review,network meta-analysis and cost-effectiveness analysis [J].Health Tech Assess, 2016, 20 (65): 1-584.
[3] Koc O, Duran B, Ozdemirci S, et al.Oxytocin versus sustained‐release dinoprostone vaginal pessary for labor induction of unfavorable cervix with Bishop score ≥4 and ≤6: A randomized controlled trial [M].Journal of Obstetrics and Gynaecology Research, 2013, 39 (4): 790-798.
[4] 施展华,晏婷.足月妊娠引产产妇应用COOK宫颈扩张球囊促宫颈成熟的效果 [J].中国妇幼保健,2018,33(7):1619-1622.
[5] 谭章敏,李玲,姜航,等.COOK球囊联合缩宫素用于足月妊娠引产效果的预测指标分析 [J].新医学,2017,48(10):727-731.
[6] SCISCIONE, Anthony C .Methods of Cervical Ripening and Labor Induction:Mechanical [J].Clinical Obstetrics & Gynecology, 2014, 57 (2):369-376.
[7] 董晓超,徐宁,王志华.子宫颈扩张球囊引产效果影响因素与预测模型研究 [J].中国实用妇科与产科杂志,2016,32(10):990-993.
[8] 吴爱华,黎璞,田耕,等.双球囊引产不同注水量对分娩结局的影响 [J].广东医学,2015,36(11):1681-1683.
[9] 苏梅.双球囊导管不同时间放置对促宫颈成熟与引产方面的研究 [J].医学理论与实践,2013,26(20):2736-2738.
[10] 陈颖文.COOK球囊配合缩宫素引产失败分析 [J].临床和实验医学杂志,2015,14(11):927-930.
[11] 侯海静, 陈羽, 余颖,等.三腔导尿管球囊、COOK 球囊、欣普贝生三种不同方法对孕晚期促宫颈成熟与引产效果观察 [J].江西中医药大学学报, 2018,30(2):47-50.
[12] 周新娥, 陈媛, 程薇, 等.Cook 宫颈扩张球囊用于足月妊娠促宫颈成熟及引产的临床分析[J].四川医学, 2013, 34(9):1334-1336.
[13] 孙桂蓉.催产素联合COOK宫颈扩张球囊用于足月妊娠引产的效果分析 [J].中国妇幼保健, 2016, 31(3):646-648.
[14] 陆小娟, 张弘, 刘琴,等.球囊宫颈扩张器引产及其影响效果的多因素Logistic回归分析 [J].中国计划生育和妇产科, 2017,9(12):36-40.
[15] 金凤, 孙瑜, 廖秦平.妊娠晚期引产指征和成功率的探讨 [J].中国妇产科临床杂志, 2009, 10 (4):248-251.
[16] 任立新, 孙东霞, 杨艳景,等.延期妊娠60例引产失败的临床分析 [J].河北医科大学学报, 2015, 36 (3):341-343.
[2] ALFIREVIC Z, KEENEY E, DOWSWELL T, et al.Which method is best for the induction of labour? A systematic review,network meta-analysis and cost-effectiveness analysis [J].Health Tech Assess, 2016, 20 (65): 1-584.
[3] Koc O, Duran B, Ozdemirci S, et al.Oxytocin versus sustained‐release dinoprostone vaginal pessary for labor induction of unfavorable cervix with Bishop score ≥4 and ≤6: A randomized controlled trial [M].Journal of Obstetrics and Gynaecology Research, 2013, 39 (4): 790-798.
[4] 施展华,晏婷.足月妊娠引产产妇应用COOK宫颈扩张球囊促宫颈成熟的效果 [J].中国妇幼保健,2018,33(7):1619-1622.
[5] 谭章敏,李玲,姜航,等.COOK球囊联合缩宫素用于足月妊娠引产效果的预测指标分析 [J].新医学,2017,48(10):727-731.
[6] SCISCIONE, Anthony C .Methods of Cervical Ripening and Labor Induction:Mechanical [J].Clinical Obstetrics & Gynecology, 2014, 57 (2):369-376.
[7] 董晓超,徐宁,王志华.子宫颈扩张球囊引产效果影响因素与预测模型研究 [J].中国实用妇科与产科杂志,2016,32(10):990-993.
[8] 吴爱华,黎璞,田耕,等.双球囊引产不同注水量对分娩结局的影响 [J].广东医学,2015,36(11):1681-1683.
[9] 苏梅.双球囊导管不同时间放置对促宫颈成熟与引产方面的研究 [J].医学理论与实践,2013,26(20):2736-2738.
[10] 陈颖文.COOK球囊配合缩宫素引产失败分析 [J].临床和实验医学杂志,2015,14(11):927-930.
[11] 侯海静, 陈羽, 余颖,等.三腔导尿管球囊、COOK 球囊、欣普贝生三种不同方法对孕晚期促宫颈成熟与引产效果观察 [J].江西中医药大学学报, 2018,30(2):47-50.
[12] 周新娥, 陈媛, 程薇, 等.Cook 宫颈扩张球囊用于足月妊娠促宫颈成熟及引产的临床分析[J].四川医学, 2013, 34(9):1334-1336.
[13] 孙桂蓉.催产素联合COOK宫颈扩张球囊用于足月妊娠引产的效果分析 [J].中国妇幼保健, 2016, 31(3):646-648.
[14] 陆小娟, 张弘, 刘琴,等.球囊宫颈扩张器引产及其影响效果的多因素Logistic回归分析 [J].中国计划生育和妇产科, 2017,9(12):36-40.
[15] 金凤, 孙瑜, 廖秦平.妊娠晚期引产指征和成功率的探讨 [J].中国妇产科临床杂志, 2009, 10 (4):248-251.
[16] 任立新, 孙东霞, 杨艳景,等.延期妊娠60例引产失败的临床分析 [J].河北医科大学学报, 2015, 36 (3):341-343.