| 张 然,高 静,邓海云,刘 丹,刘雪芹.双腔水囊联合腹主动脉介入阻隔术对比催产素联合常规剖宫产在晚期妊娠糖尿病引产中的应用分析[J].,2021,(8):1545-1549 |
| 双腔水囊联合腹主动脉介入阻隔术对比催产素联合常规剖宫产在晚期妊娠糖尿病引产中的应用分析 |
| Application of Double Cavity Water Capsule Combined with Abdominal Aorta Interventional Occlusion Compared with Oxytocin Combined with Routine Cesarean Section in the Induction of Late Gestational Diabetes Ellitus |
| 投稿时间：2020-08-23 修订日期：2020-09-18 |
| DOI：10.13241/j.cnki.pmb.2021.08.032 |
| 中文关键词: 晚期妊娠糖尿病 双腔水囊 腹主动脉介入阻隔术 催产素 剖宫产 引产 |
| 英文关键词: Late gestational diabetes mellitus Double cavity water capsule Abdominal aorta interventional occlusion Oxytocin Cesarean section Induced labor |
| 基金项目:河北省科技支撑计划项目（191460753） |
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| 中文摘要: |
| 摘要 目的：探讨双腔水囊联合腹主动脉介入阻隔术对比催产素联合常规剖宫产对于晚期妊娠糖尿病引产的临床疗效。方法：收集2019年9月至2020年4月在我院待产的146例晚期妊娠糖尿病患者，随机分为研究组（73例）和对照组（73例）。研究组首先采用双腔水囊置于宫颈引产，对于双腔水囊引产失败的患者则采用腹主动脉介入阻隔术情况下剖宫产；对照组采用单纯静脉滴注小剂量催产素引产，对于催产素引产失败的患者则行常规剖宫产。通过询问病史、体征检查、实验室检查等收集孕妇一般情况、引产前后宫颈Bishop评分、各产程情况、不良反应等数据；引产失败的部分患者收集手术时间、输血量、出血量、子宫切除率、新生儿Apgar评分。对比分析两组患者促宫颈成熟度、各产程情况、妊娠结局、不良反应等结果。结果：研究组孕妇宫颈Bishop评分治疗后高于对照组（P＜0.05）；研究组与对照组在宫颈Bishop评分提高上比较差异有统计学意义（P＜0.05）。研究组引产成功率高于对照组，对照组剖宫产率高于研究组，两组分娩结局比较差异有统计学意义（P＜0.05）。研究组引产开始至临产时间、第一产程、第二产程、总产程时间上短于对照组（P＜0.05）。研究组术中出血量、输血量、子宫切除率及新生儿Apgar评分均少于对照组（P＜0.05）。研究组不良反应发生例数低于对照组（P＜0.05）。结论：双腔水囊、催产素均可促宫颈成熟，但前者优于后者且可提高引产成功率；腹主动脉介入阻隔术的应用较常规剖宫产优势更为明显，对于晚期妊娠糖尿病孕妇采用双腔水囊联合腹主动脉介入阻隔术引产具有更高安全性，值得临床借鉴。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical effect of double cavity water capsule combined with abdominal aorta interventional occlusion compared with oxytocin combined with routine cesarean section in the induction of late gestational diabetes mellitus. Methods: From September 2019 to April 2020,146 patients with late gestational diabetes waiting for labor in our hospital were randomly divided into study group (73 cases) and control group (73 cases). In the study group, the double cavity water capsule was placed in the cervix to induce labor, and in the case of failure of double cavity water capsule to induce labor, the abdominal aorta interventional occlusion was used to block the cesarean section. In the control group, the single intravenous drip of low-dose oxytocin was used to induce labor, and in the case of failure of oxytocin induced labor, the conventional cesarean section was used. The general condition of pregnant women, Bishop score of cervix before and after induction of labor, condition of each stage of labor, adverse reactions and other data were collected by asking medical history, physical examination and laboratory examination. The operation time, blood transfusion amount, bleeding amount, hysterectomy rate and Apgar score of newborn were collected by some patients who failed to induce labor. The results of cervical maturity, labor process, pregnancy outcome and adverse reactions were compared between the two groups. Results: The cervical Bishop score of the pregnant women in the study group was higher than that in the control group after treatment(P<0.05); there was statistically significant difference between the study group and the control group in the cervical Bishop score increased(P<0.05). The induced labor success rate in the study group was higher than that in the control group, and the cesarean section rate in the control group was higher than that in the study group(P<0.05). The labor induction to labor time, the first stage, the second stage and the total stage of labor in the study group were shorter than those in the control group(P<0.05). The intraoperatve blood soss, blood transfusion volume, hysterectomy rate and Apgar score of newborns in the study group were lower than those in the control group (P<0.05). The number of adverse reactions in the study group was lower than that in the control group (P<0.05). Conclusion: Double cavity water capsule and oxytocin can promote cervical ripening, but the former is better than the latter and can improve the success rate of induced labor; the application of abdominal aorta interventional occlusion is more obvious than that of conventional cesarean section, which has a higher safety for late gestational diabetes mellitus to use double cavity water capsule combined with abdominal aorta interventional occlusion for induction of labor, which is worthy of clinical reference. |
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