摘要目的 探讨COOK宫颈球囊扩张器促宫颈成熟的使用时限。方法 选取2018年2月～2019年12月在景德镇市第一医院进行引产的105例孕足月产妇作为研究对象，依据随机数字表法将入选产妇分为观察组（52例）与对照组（53例）。对照组产妇引产前一天的晚8时放置COOK宫颈球囊引产，次日早8时取出，共放置12 h。观察组产妇引产前一天的晚10时放置COOK宫颈球囊引产，次日早6时取出，共放置8 h。记录放置球囊前、取出球囊时的宫颈评分、胎心监护评分、孕妇体温，比较两组的第一产程、第二产程及第三产程。结果 两组放置球囊前的宫颈评分、胎心监护评分比较，差异无统计学意义（P>0.05）。两组取出球囊时的宫颈评分、胎心监护评分高于放置球囊前，差异有统计学意义（P<0.05）。两组取出球囊时的宫颈评分、胎心监护评分比较，差异无统计学意义（P>0.05）。两组放置球囊前的体温比较，差异无统计学意义（P>0.05）。两组取出球囊时的体温与放置球囊前比较，差异无统计学意义（P>0.05）。两组取出球囊时的体温比较，差异无统计学意义（P>0.05）。观察组的第一产程、第二产程及第三产程与对照组比较，差异无统计学意义（P>0.05）。两组放置球囊前的C反应蛋白、降钙素原及白细胞计数水平比较，差异无统计学意义（P>0.05）。对照组取出球囊时的C反应蛋白、降钙素原及白细胞计数水平高于放置球囊前，差异有统计学意义（P<0.05）。观察组取出球囊时的C反应蛋白、降钙素原及白细胞计数水平低于对照组，差异有统计学意义（P<0.05）。观察组取出球囊时的C反应蛋白、降钙素原及白细胞计数水平与放置球囊前比较，差异无统计学意义（P>0.05）。结论 COOK宫颈球囊扩张器促宫颈成熟的效果显著，能够显著提高宫颈评分、胎心监护评分，且放置8 h 的效果与12 h 相当，因此临床首选放置8 h。但是放置12 h 可以提高C反应蛋白、降钙素原及白细胞计数水平，因此，临床医师可根据孕妇的情况选择放置时间。
Abstract：Objective To explore the usage time of COOK cervical balloon dilator to promote cervical maturation.Methods A total of 105 pregnant and full-term women who had induced labor in Jingdezhen First Hospital from February 2018 to December 2019 were selected as the study objects.According to the random number table method，the selected patients were divided into the observation group (52 cases) and the control group (53 cases).In the control group,COOK cervical balloon was placed at 8∶00 p.m.of the day before induction of labor,and which was taken out at 8∶00 a.m.of the next day,it was placed for 12 h.In the observation group,COOK cervical balloon was placed at 10∶00 p.m.of the day before induction of labor,and which was taken out at 6∶00 a.m.of the next day,it was placed for 8 h.The cervical score,fetal heart rate monitoring score and pregnant women′s body temperature before balloon placement and after removing balloon were recorded,and the first stage,second stage and third stage of labor were compared between the two groups.Results The differences were not statistically significant in cervical score and fetal heart rate monitoring score between the two groups before balloon placement (P>0.05).The cervical score and fetal heart rate monitoring score of the two groups after removing balloon were higher than those before balloon placement,with significant statistics differences (P<0.05).The differences were not statistically significant in cervical score and fetal heart rate monitoring score between the observation group and the control group after removing balloon (P>0.05).The difference was not statistically significant in body temperature between the two groups before balloon placement (P>0.05).The differences were not statistically significant in body temperatures of the two groups between before balloon placement and after removing balloon (P>0.05).The difference was not statistically significant in body temperature between the two groups after removing balloon (P>0.05).There were no significant differences between the observation group and the control group in the first,second and third stages of labor (P>0.05).There were no significant differences in the levels of C-reactive protein,procalcitonin and leukocyte count between the two groups before balloon placement (P>0.05).The levels of C-reactive protein,procalcitonin and leukocyte count in the control group after removing balloon were higher than those before balloon placement,with significant statistics differences (P<0.05).The levels of C-reactive protein,procalcitonin and leukocyte count of the observation group after removing balloon were lower than those of the control group,with significant statistics differences (P<0.05).There were no significant differences in the levels of C-reactive protein,procalcitonin and leukocyte count of the observation group after removing balloon and before balloon placement (P>0.05).Conclusion The effect of COOK cervical balloon dilator to promote cervical maturation is significant,which can significantly improve cervical score and fetal heart rate monitoring score,and the effect of 8 hours of placement is equivalent to 12 hours,so 8 hours placement is the first choice clinically.However,12 hours placement can improve the levels of C-reactive protein,procalcitonin and leukocyte count.Therefore,the clinician can choose the placement time according to the condition of the pregnant woman.
李飞珍. COOK宫颈球囊扩张器促宫颈成熟使用时限探讨[J]. 中国当代医药, 2021, 28(4): 126-129.
LI Fei-zhen. Discussion on the usage time of COOK cervical balloon dilator to promote cervical maturation. 中国当代医药, 2021, 28(4): 126-129.
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