目的 探讨宫颈小水囊扩张应用于足月妊娠引产的临床效果。方法 将2014年1月—2016年6月期间在深圳市妇幼保健院妇产科行足月妊娠引产术的120例患者随机分为观察组(60例)与对照组(60例),观察组应用宫颈小水囊扩张法,对照组应用地诺前列酮栓法,对比分析两组患者的疗效。结果 (1)观察组放置时间显著长于对照组,差异有统计学意义;两组患者第一产程时间、第二产程时间、总产程时间相比差异无统计学意义。(2)组内不同时间点之间宫颈Bishop评分的比较:放置前、放置4 h后、放置8 h后、放置12 h后,观察组与对照组不同时间点之间的宫颈Bishop评分相比差异均有统计学意义,每组放置前的宫颈Bishop评分显著低于放置4 h后、放置8 h后、放置12 h后,放置4 h后的宫颈Bishop评分显著低于放置8 h后、放置12 h后,放置8 h后的宫颈Bishop评分显著低于放置12 h后。(3)不同时间点组间宫颈Bishop评分的比较:放置前、放置4 h后、放置8 h后、放置12 h后,观察组与对照组之间宫颈Bishop评分相比差异均无统计学意义。(4)两组患者发热率、剖宫产率、阴道分娩率、缩宫素使用率、产后出血量相比差异均无统计学意义。(5)两组新生儿出生1 min后、5 min后的Apgar评分,体重相比差异无统计学意义。结论 足月妊娠引产应用宫颈小水囊扩张法和地诺前列酮栓法的疗效相当,但宫颈小水囊扩张法更为经济,且作用温和,值得临床推广应用。

Objective To examine the effect of small water bag compared to dinoprostone suppositories on induction of labor in term pregnancy.Methods 120 full-term pregnant women who would undergo elective labor induction were enrolled from January 2014 to June 2016 in Maternal and Child Health Hospital of Shenzhen City,and were randomly assigned to receive either small water bag (intervention group,60 participants) or dinoprostone suppositories (control group,60 participants).Results The placement time was significantly longer in intervention group than the control group (P<0.05),whereas there was no difference in the duration of the first stage of labor,the second stage of labor, and the total time of labor. Within each group, the cervical Bishop scores assessed at different time points (before placement and 4h, 8h, and12h after placement) differed significantly, and the scores increased with the time of placement. There was no difference in the cervical Bishop scores between the intervention and control group at all the four time points. There was no significant difference in the rate of fever, cesarean section, oxytocin use, and postpartum hemorrhage between the two groups. There was also no difference in 1 min and 5 min Apgar score birth weight of neonates born to mothers of the two groups.Conclusion The effect of small water bag is comparable to that of dinoprostone suppositories on labor induction for full-term pregnancy, while the former has a lower cost and its effect is not so strong and therefore might be worthy of being generalized in clinical settings.