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目的探讨并比较COOK子宫颈扩张球囊(COOK球囊)和一次性宫颈扩张球囊(单球水囊)促宫颈成熟和分娩的效果。方法选择2014年1-6月住院初产妇243例,随机分为COOK球囊组(81例)、单球水囊组(81例)和缩宫素组(81例),对3组产妇给予促宫颈成熟。观察并比较3组促宫颈成熟的效果、放置球囊至取出阴道的出血量、放置球囊后疼痛时间、第一产程时间、自然分娩率及剖宫产率。结果 COOK球囊组及单球水囊组促宫颈成熟成功率分别为97.53%和93.83%,均高于缩宫素组(37%),差异均有统计学意义(χ~2=123.89,P<0.05;χ~2=115.50,P<0.05);COOK球囊组及单球水囊组放置球囊至取出阴道的出血量分别为(24.19±4.04)ml和(62.75±15.39)ml,两组比较差异有统计学意义(t=6.42,P<0.05);COOK球囊组及单球水囊组放置球囊后疼痛时间分别为(3.44±1.41)h和(6.38±2.22)h,两组比较差异有统计学意义(t=10.06,P<0.05);COOK球囊组及单球水囊组剖宫产率分别为19.75%和22.22%,均低于缩宫素组(35.80%),差异均有统计学意义(χ~2=10.40,P<0.05;χ~2=7.25,P<0.05)。结论 COOK球囊和单球水囊均可较快促进宫颈成熟,缩短产程,提高阴道分娩率,降低剖宫产率。COOK球囊在改善宫颈成熟度方面优于单球水囊,产妇的不适感也少于单球水囊。
Objective To explore and compare the effect of COOK cervical balloon (COOK balloon) and disposable cervical dilatation balloon (balloon) in promoting cervical ripening and delivery. Methods Totally 243 primipara from January to June 2014 were randomly divided into three groups: the COOK balloon group (81 cases), the single balloon water capsule group (81 cases) and the oxytocin group (81 cases) Cervical maturity. Observe and compare the effects of cervical ripening, bleeding volume of the balloon to vaginal discharge, pain time after balloon placement, time of first delivery, spontaneous delivery rate and cesarean section rate. Results The success rates of cervical ripening in COOK balloon group and single balloon group were 97.53% and 93.83%, respectively, which were significantly higher than those in oxytocin group (37%) (χ ~ 2 = 123.89, P (24.19 ± 4.04) ml and (62.75 ± 15.39) ml, respectively, in the COOK balloon group and the single balloon group were significantly lower than those in the balloon group (P <0.05; χ ~ 2 = 115.50, P < (T = 6.42, P <0.05). The pain time after balloon placement in COOK balloon group and balloon balloon group were (3.44 ± 1.41) h and (6.38 ± 2.22) h, respectively, and the difference was statistically significant (T = 10.06, P <0.05). The rates of cesarean section in COOK balloon group and single balloon balloon group were 19.75% and 22.22% respectively, which were all lower than those in oxytocin group (35.80%) , The differences were statistically significant (χ ~ 2 = 10.40, P <0.05; χ ~ 2 = 7.25, P <0.05). Conclusion Both COOK balloon and single balloon can promote cervical maturation, shorten labor process, increase vaginal delivery rate and reduce cesarean section rate. The COOK balloon is superior to a single balloon in improving cervical maturity, and maternal discomfort is less than that of a single balloon.