Bakri球囊用于剖宫产术后大出血的治疗和护理效果分析  

Bakri Balloon for Treatment and Nursing Effect Analysis of Massive Bleeding after Cesarean Section

作　　者：杨剑芳 丽琼 Yang Jianfang;Li Qiong(Shenzhen Longhua District People's Hospital,Shenzhen,Guangdong 518109,China)

机构地区：[1]深圳市龙华区人民医院,广东深圳518109

出　　处：《四川医学》2020年第2期216-219,共4页Sichuan Medical Journal

摘　　要：目的分析探讨Bakri球囊用于剖宫产术后大出血的治疗和护理效果,总结产科治疗经验,提高护理水平。方法选取我院产科病房2017年6月至2018年6月间收治的59例剖宫产术后大出血患者作为研究对象,随机分为两组。对照组29例,给予B-Lynch缝合治疗;观察组30例,采用Bakri球囊填塞治疗。比较两组产妇的术中、术后2h、24h出血量和总输血量;比较两组产妇术前、术后2h凝血酶原时间(PT)、血浆凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)等凝血时间和相关分子水平等指标;比较两组产妇术后不良结局发生情况。结果观察组术中出血量、术后2h出血量、总输血量均显著低于对照组,差异有统计学意义(P<0.05);术后24h出血量差异无统计学意义(P>0.05)。产后2h对照组PT、TT均显著增高,FIB及D-D显著降低,差异有统计学意义(P<0.05);观察组PT较产前显著增高,FIB较产前显著降低,差异有统计学意义(P<0.05),而TT、D-D差异无统计学意义(P>0.05)。产后2h,观察组TT显著低于对照组,FIB、D-D显著高于对照组,差异有统计学意义(P<0.05)。对照组伤口感染率与子宫切除率均显著高于观察组,差异有统计学意义(P<0.05)。结论Bakri球囊应用于剖宫产术后大出血产妇时早期止血效果强,患者术后感染率低,不良结局发生率低,建议临床推广应用。Objective To analyze and discuss the effect of bakri balloon on the treatment and nursing of massive bleeding after cesarean section,summarize the experience of obstetric treatment and improve the nursing level.Methods A total of 59 patients with massive bleeding after cesarean section who were admitted to the obstetric ward of our hospital from June 2017 to June 2018 were selected as the research objects and randomly divided into two groups.The control group(29 cases)was treated with B-Lynch suture and the observation group(30 cases)was treated with Bakri balloon tamponade.Compare the intraoperative,postoperative 2h,and 24h postpartum hemorrhage and total blood transfusion between two groups of women.Compare the coagulation time and related molecular levels such as prothrombin time(PT),plasma thrombin time(TT),fibrinogen(FIB),and D-dimer(DD)between the two groups of women before and 2 hoursafter surgery.The incidence of postoperative adverse outcomes between the two groups was compared.Results The intraoperative blood loss,2h postoperative blood loss,and total blood transfusion volume in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in 24hours postoperative bleeding volume between the two groups(P>0.05).The PT and TT in the control group were significantly increased and the FIB and D-D were significantly decreased at 2 hoursafter surgery.The difference was statistically significant(P<0.05).In the observation group,the PT was significantly higher than that before antenatal,the FIB was significantly lower than that before antenatal,and the difference was statistically significant(P<0.05),but the difference between TT and D-D had not statistically significant(P>0.05).at 2 hoursafter surgery,TT in the observation group was significantly lower than that in the control group,and FIB and D-D were significantly higher than those in the control group,and the difference was statistically signific

关 键 词：剖宫产术 产后出血 Bakri球囊 护理 

分 类 号：R714.461[医药卫生—妇产科学]