宫腔球囊填塞在治疗前置胎盘产妇剖宫产术后出血中的应用  

Application of intrauterine balloon tamponade in treatment of postpartum hemorrhage after cesarean section in pregnant women with placental previa

作　　者：孟茜[1] 陈海霞[1] 莫应萍[1] 李善凤[1] 骆秀翠[1] 

机构地区：[1]江苏省连云港市妇幼保健院产科扬州大学医学院附属医院,222006

出　　处：《中国妇幼保健》2015年第6期957-959,共3页Maternal and Child Health Care of China

摘　　要：目的：观察宫腔球囊填塞治疗前置胎盘产妇剖宫产术中及术后出血的有效性和安全性。方法：将2013年1月~2014年5月实施剖宫产术的38例前置胎盘产妇分为对照组（缩宫素20 U＋卡前列素250μg宫体注射,25例）和观察组（缩宫素20 U＋卡前列素250μg宫体注射,同时宫腔球囊填塞术,13例）。计算两组术中及术后2和24 h总出血量,观察两组术后不良反应发生情况。结果：对照组和观察组术中出血量分别为（506±88）ml和（540±24）ml,差异无统计学意义（P〉0.05）;对照组和观察组术后2 h出血量分别为（116±20）ml和（11±3）ml,差异有统计学意义（P〈0.05）;对照组和观察组术后24 h出血量分别为（764±69）ml和（588±23）ml,差异有统计学意义（P〈0.05）;两组产后出血量≥1 000 ml共6例,其中对照组4例（16.00%,4/25）、观察组2例（15.38%,2/13）;两组均无子宫切除病例、无明显的不良反应。结论：宫腔球囊填塞技术治疗前置胎盘产妇剖宫产术中及术后出血有效、简便,值得推广。Objective： To observe the effectiveness and safety of intrauterine balloon tamponade in treatment of intraoperative and postoperative hemorrhage of cesarean section in pregnant women with placental previa. Methods： Thirty - eight pregnant women with pla- cental previa treated with cesarean section from January 2013 to May 2014 were divided into control group （25 women treated with myometrial injection of 20 U oxytocin and 250 μg carboprost） and observation group （ 13 women treated with myometrial injection of 20 U oxytocin and 250 μg carboprost combined with intrauterine balloon tamponade） . The amounts of intraoperative hemorrhage and postoperative hemorrhage at 2 and 24 hours were calculated; the adverse reactions in the two groups were observed. Results： The amounts of intraoperative hemor- rhage in control group and observation group were （506 ± 88） ml and （540 ± 24） ml, respectively, there was no statistically significant difference between the two groups （ P 〉 0. 05 ） ; the amounts of postoperative hemorrhage at 2 hours in control group and observation group were （116 ±20） ml and （11 ±3 ） ml, respectively, there was statistically significant difference between the two groups （P 〈 0.05 ） ; the a- mounts of postoperative hemorrhage at 24 hours in control group and observation group were （764 ± 69） ml and （588 ± 23 ） ml, respectively, there was statistically significant difference between the two groups （ P 〈 0. 05 ） . Six women were found with postpartum hemorrhage ≥1 000 ml, including four women in control group （ 16. 00%, 4/25） and two women in observation group （ 15.38%, 2/13 ） . No hysterectomy was performed in the two groups, no significant adverse reactions occurred. Conclusion： Intrauterine balloon tamponade is an effective and sim- ple means in treatment of postpartum hemorrhage after cesarean section in pregnant women with placental previa, and the method is worthy of clinical popularization.

关 键 词：宫腔球囊填塞 前置胎盘 术后出血 

分 类 号：R714.69[医药卫生—妇产科学]