经会阴超声测量宫颈长度对双胎先兆早产患者应用不同疗程阿托西班治疗的临床效果评估

目的:使用经会阴超声测量宫颈长度(CL)来评估不同疗程阿托西班治疗双胎妊娠先兆早产的疗效。方法:纳入2017年3月—2019年12月我院就诊的双胎妊娠妇女60例作为研究对象,随机数字表法将两组患者分为A组和B组,每组30例,均采用阿托西班治疗,A组予长疗程方案,B组使用短疗程方案。观察两组临床疗效、治疗前后CL、不良反应、分娩孕周、保胎成功率以及分娩后新生儿体质量、出生1 min的Apgar评分。结果:A组患者在48 h、7 d的有效率分别为83.33%和96.67%,均显著高于B组的60%和76.67%,差异具有统计学意义(P<0.05)。两组患者在治疗前CL无统计学差异(P>0.05),经治疗后A组患者的CL显著长于B组,差异具有统计学意义(P<0.05)。A组中不良反应发生率为13.33%,高于B组的10%,但差异无统计学意义(P>0.05)。A组平均分娩孕周显著高于B组,差异具有统计学意义(P<0.05)。A组保胎成功率为96.67%,高于B组的93.33%,但差异无统计学意义(P>0.05)。A组体质量及Apgar评分均稍大于B组,但差异均无统计学意义(P>0.05)。结论:在双胎先兆早产中运用阿托西班可取得一定疗效,与短疗程方案相比较,长疗程方案可取得更好的临床效果,有助于延长孕周。但二者在保胎成功率、新生儿情况方面无显著差异。

Evaluation of clinical effect of different courses of treatment with Atosiban in twin pregnancies in threatened preterm labor using transperineal sonographic measurement of cervical length

Objective:To evaluate the therapeutic effect of different courses of Atosiban in the treatment of twin pregnancies in threatened preterm labor by measuring the length of cervix(CL)with transperineal ultrasound.Methods:Sixty twin pregnant women who were treated in our hospital from March 2017 to December 2019 were included as the research objects.The two groups were divided into group A and group B by the method of random number table,30 cases in each group were treated with Atosiban,group A with long course plan,and group B with short course plan.The clinical efficacy,CL before and after treatment,adverse reactions,gestational weeks of delivery,the success rate of fetal protection,the weight of newborn after delivery and Apgar score of one minute after birth were observed.Results:The effective rates of group A were 83.33%and 96.67%at 48 h and 7 d,respectively,which were significantly higher than those of group B(60%and 76.67%)(P<0.05).There was no significant difference in CL between the two groups before treatment(P>0.05).After treatment,CL in group A was significantly longer than that in group B(P<0.05).The incidence of adverse reactions in group A was 13.33%,which was higher than 10%in group B,but the difference was not statistically significant(P>0.05).The average gestational age of group A was significantly higher than that of group B(P<0.05).The success rate of group A was 96.67%,higher than that of group B(93.33%),but the difference was not statistically significant(P>0.05).The body weight and Apgar score of group A were slightly higher than those of group B,but the difference was not statistically significant(P>0.05).Conclusion:Compared with the short course of treatment,the long course of treatment can achieve better clinical effect and prolong the gestational period.However,there was no significant difference in the success rate of fetal protection and newborn condition between the two groups.