Bakri子宫填塞球囊导管在前置胎盘剖宫产术中的应用  

Application of Bakri Uterine Tamponade Balloon Catheter in Cesarean Section of Placenta Previa

作　　者：崔金晖[1] 李萍[1] 张媛[1] 范建辉[1] 

机构地区：[1]中山大学附属第三医院产科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2014年第4期565-569,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2011B061300030)

摘　　要：[目的]探讨Bakri子宫填塞球囊导管对前置胎盘剖宫产术中止血的治疗效果.[方法]对2011年5月1日至2013年9月30日在中山大学附属第三医院及岭南分院分娩的前置胎盘患者进行回顾分析,将剖宫产术中出血均大于500mL者纳入研究,入组病例共74例,按照是否应用Bakri子宫填塞球囊导管止血进行分组,应用Bakri子宫填塞球囊导管者（研究组）34例,未应用Bakri子宫填塞球囊导管者（对照组）40例,对两组患者的年龄、孕次、分娩周数、新生儿出生体质量、产后24 h出血量、手术时间、术后白细胞及中性粒细胞、子宫切除情况进行对比分析,从而探讨Bakri子宫填塞球囊导管对前置胎盘剖宫产术中止血的治疗效果.将放置Bakri子宫填塞球囊导管后出血减少,无需采取其他治疗措施者定义为治疗成功.[结果]两组比较,患者年龄、孕次、分娩孕周、新生儿出生体质量、产后24h出血量及白细胞、中性粒细胞对比差异无统计学意义（P＞0.05）.研究组急诊手术13例,手术时间52.79（35～ 85）min;对照组5例,手术时间74.33（40 ～ 330）min,差异有统计学意义（P＜0.05）.研究组中2例放置Bakfi子宫填塞球囊导管后因持续性阴道出血行介入子宫动脉栓塞术,治疗成功32例,成功率为94.12％,无子宫切除病例,对照组中5例行子宫次全切除术,差异有统计学意义（P＜0.05）.[结论]Bakri子宫填塞球囊导管放置简单快速,可实时观察出血量,可以有效地控制前置胎盘剖宫产术中及产后出血,不增加产褥感染风险,可降低子宫切除率.[Objective]To study the therapeutic effect of Bakri uterine tamponade balloon catheter in cesarean section of placenta previa.[Methods]A retrospective case-control analysis of the patients with placenta previa during May 1,2011 to September 30,2013 at the Third Affiliated Hospital of Sun Yat-sen University and its Lingnan Branch.Seventy-four patients with bleeding greater than 500 mL were enrolled in the study.Thirty-four cases were treated with Bakri uterine tamponade balloon catheter （Study group）,and forty cases without Bakri uterine tamponade balloon catheter （Control group）.Through the comparison and analysis of patients＇ age,gravidity,gestational age at delivery,birthweight,bleeding amount within 24 h after operation,operation time,Leukocyte and Neutrophils count at 24 h after operation and number of hysterectomy in the two groups,the clinical effect of Bakri uterine tamponade balloon catheter in the treatment of postpartum hemorrhage was studied.Bleeding reduced without taking other therapeutic measures was defined as success.[Results]The differences of age,gravidity,gestational age at delivery,birthweight,bleeding amount within 24 h after operation,Leukocyte and Neutrophils count at 24 h after operation between two groups were not statistically significant （P 〉 0.05）.There were 13 emergency operations in study group,and 5 in control group,the difference was statistically significant （P 〈 0.05）.The average operation time of study group and control group were 52.79 （35-85） min and 74.33 （40-330） min respectively,with statistically significance （P 〈 0.05）.In study group,two patients needed interventional embolization due to continued vaginal bleeding,and no hysterectomy applied.The overall effective rate was 94.12%.There were 5 cases needed hysterectomy in control group.The difference was statistically significant （P 〈 0.05）.[Conclusion]Insertion of Bakri uterine tamponade balloon catheter is a simple and rapid alternative procedure with real-time observation of blee

关 键 词：Bakri子宫填塞球囊导管 前置胎盘 产后出血 

分 类 号：R714.4[医药卫生—妇产科学]