宫腔球囊与纱布填塞在瘢痕妊娠清宫手术大出血中的应用对比  

Comparison of the Application of intrauterine Balloon and Gauze Tamponade in the Treatment of massive Bleeding during Scar Pregnancy Curettage Surgery

作　　者：张春霞 杨红灵 许淑荣 ZHANG Chunxia;YANG Hongling;XU Shurong(Department of Obstetrics and gynecology,Zhoukou Maternity Hospital,Zhoukou Henan 466000,China)

机构地区：[1]周口妇产医院妇产科,河南周口466000

出　　处：《临床研究》2023年第10期71-74,共4页Clinical Research

摘　　要：目的探讨宫腔球囊与纱布填塞在瘢痕妊娠清宫手术大出血中的应用。方法回顾性分析于周口妇产医院2016年4月至2022年4月入院行清宫手术大出血的64例瘢痕妊娠患者的临床资料,根据其止血方式的不同分为球囊组与纱布组,其中球囊组35例患者采用宫腔球囊止血,纱布组29例患者采用纱布填塞止血。对比两组患者的临床相关指标、手术前后的应激反应指标、止血有效率以及并发症发生情况。结果相较于纱布组,球囊组患者手术时间及止血时间明显更短,术中出血量及术后24 h内出血量均明显更少,差异有统计学意义(P<0.05);相较于术前,两组患者术后去甲肾上腺素(NE)、皮质醇(Cor)及促肾上腺皮质激素(ACTH)水平均明显升高,差异有统计学意义(P<0.05);相较于纱布组,球囊组患者术后NE、Cor、ACTH水平明显更低,差异有统计学意义(P<0.05);相较于纱布组,球囊组患者止血有效率明显更高,差异有统计学意义(P<0.05);相较于纱布组,球囊组患者总并发症发生率明显更低,差异有统计学意义(P<0.05)。结论瘢痕妊娠清宫手术大出血中,采用宫腔球囊止血较纱布填塞止血可减少出血量、缩短止血时间与手术时间,止血效果更好,患者应激反应较轻,更为安全可靠。Objective To explore the application of intrauterine balloon and gauze tamponade in the treatment of massive bleeding during scar pregnancy curettage surgery.Methods The clinical data of 64 cases of scar pregnancy with massive hemorrhage after curettage from April 2016 to April 2022 were analyzed retrospectively,they were divided into a balloon group and a gauze group based on their different hemostatic methods.Among them,35 patients in the balloon group received intrauterine balloon hemostasis,while 29 patients in the gauze group received gauze tamponade hemostasis.The clinical related indicators,stress response indicators before and after surgery,hemostatic efficacy,and incidence of complications between the two groups of patients were compared.Results Compared with the gauze group,the balloon group had significantly shorter surgical time and hemostasis time,with significantly less intraoperative and postoperative bleeding within 24 hours,and the difference was statistically significant(P<0.05);Compared to before surgery,the levels of norepinephrine(NE),cortisol(Cor),and adrenocorticotropic hormone(ACTH)in both groups of patients increased significantly after surgery,with a statistically significant difference(P<0.05);Compared with the gauze group,the postoperative NE,Cor,and ACTH levels in the balloon group were significantly lower,with a statistically significant difference(P<0.05);Compared to the gauze group,the balloon group had significantly higher hemostatic efficacy,with a statistically significant difference(P<0.05);Compared to the gauze group,the total incidence of complications in the balloon group was significantly lower,with a statistically significant difference(P<0.05).Conclusion In the treatment of massive bleeding during scar pregnancy curettage surgery,using intrauterine balloon hemostasis can reduce bleeding volume,shorten hemostasis time and surgical time,and have a better hemostatic effect.Patients have a lighter stress response,which is safer and more reliable.

关 键 词：宫腔球囊 纱布填塞 瘢痕妊娠 清宫手术 

分 类 号：R714.25[医药卫生—妇产科学]