摘要
目的评估Bakri球囊填塞治疗中央型前置胎盘产后出血的有效性、安全性及使用技巧。方法回顾性分析2012年1月至2014年12月在我院产科应用Bakri球囊和宫腔纱条填塞治疗产后出血的共计272例中央型前置胎盘病例资料。其中使用Bakri球囊选为试验组(n=125),使用宫腔纱条填塞选为对照组(n=147)。分析比较两组受试者24h出血量、手术时间、住院时间,输血、子宫切除和止血无效行介入手术或再次开腹手术的不良事件发生率。结果两组受试者一般临床资料比较,其差异无统计学意义(P>0.05)。试验组产后24h出血量显著低于对照组(P<0.05),手术时间和住院时间显著短于对照组(P<0.05),子宫切除和止血无效行介入手术或再次开腹手术的不良事件发生率显著少于对照组(P<0.05)。输血的人数和子宫切除数两组比较差异无统计学意义(P>0.05),但对照组发生率高于试验组。试验组5(4.0%)例患者出现发热,4(3.2%)例病员球囊脱出,3(2.4%)例病员发生引流管封堵,导致宫腔积血。对照组11(7.48%)例出现发热,高于试验组,但差异无统计学意义(P>0.05)。结论 Bakri球囊填塞治疗中央型前置胎盘产后出血安全、有效,应严格根据子宫腔的大小和张力决定注入Bakri球囊的液体量;放置球囊成功后的24h内一定要对患者进行严密监护,保持其引流管畅通,提高引流效果。
Objective To evaluate the effectiveness, safety and usage skills of Bakri balloon packing in the treatment of postpartum hemorrhage of central placenta previa. Methods Retrospective analyze the clinical data of 272 cases of central placen- ta previa that appeared hemorrhage by treatment of Bakri balloon and intrauterine packing with gauze in the Department of Obstet- rics of Chengdu women and chardren Center Hospital from January 2012 to December 2014. Bakri balloon was selected as the ex- perimental group（ n = 125 ）, and intrauterine packing with gauze was selected as the control group（ n = 147 ）. The blood loss in 24 hours, operation time, hospitalization time and incidence rate of adverse events after interventional operation or re-laparotomy when blood transfusion, hysterectomy and bemostasis were not performed were analyzed and compared between the two groups. Results There was no significant difference between the two groups in the general clinical data（ P 〉 0. 05 ）. The amount of bleeding after 24 hours of the experimental group was significantly lower than that of control group （ P 〈 0. 05 ）, operation time and hospitalization time was significantly shorter than that of the control group（P 〈0. 05 ） ,incidence rate of adverse events after interventional opera- tion or re-laparotomy when hysterectomy and hemostasis were not performed was significantly lower than that of the control group （ P 〈 0. 05 ）. The difference of number of blood transfusion and hysterectomy number between the two groups had no significant difference （P 〉 0. 05 ）, but the control group was higher than that of experiment group. In the experimental group, 5 （4. 0% ）cases of patient had fever,4 （3.2%）cases of patient had balloon prolapse,3 （2.4%）cases of patient had drainage tube plugging, resulting in hematocele in uterine cavity. In the control group, 11 （7.48 % ）patients had fever, it was higher than the experimental group, but the difference was not statistically significant （P 〉 0. 05）. Conclusion BakriBakri balloon packing in the treatment of postpartum hemorrhage of the central placenta previa is safe and effective. We should confirm the injection volume of liquid Bakri balloonstrictly according to the uterine cavity size and tension;patients should be tightly monitored within 24 hours after the balloon was placed successfully, keeping the drainage tube flow and improving the drainage effect.
出处
《四川医学》
CAS
2016年第4期361-364,共4页
Sichuan Medical Journal
基金
国家自然科学基金项目(编号:81202217)
关键词
Bakri球囊
中央型前置胎盘
产后出血
宫腔纱条填塞
bakri balloon
central placenta previa
postpartum hemorrhage
intrauterine packing with gauze
