宫腔球囊联合水囊放置术在前置胎盘剖宫产后出血患者中的应用  

Application of intrauterine balloon combined with water sac placement in patients with placenta previa bleedingafter cesarean section

作　　者：胡会平 高湘玲[2] 张志成 HU Hui-ping;GAO Xiang-ling;ZHANG Zhi-cheng(Department of Obstetrics and Gynecology,People's Hospital Puyang County,Puyang 457000,Henan,CHINA;Department of Obstetrics and Gynecology,Puyang People's Hospital,Puyang 457000,Henan,CHINA;School of Medical Technology,Puyang Medical College,Puyang 457000,Henan,CHINA)

机构地区：[1]濮阳县人民医院妇产科,河南濮阳457000 [2]濮阳市人民医院产科,河南濮阳457000 [3]濮阳医学高等专科学校医学技术学院,河南濮阳457000

出　　处：《海南医学》2024年第16期2330-2333,共4页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20190366)。

摘　　要：目的探讨宫腔球囊联合水囊放置术在前置胎盘剖宫产后出血患者中的应用效果。方法选取2019年1月至2024年2月在濮阳县人民医院妇产科接受宫腔球囊联合水囊放置治疗的38例前置胎盘剖宫产后出血孕妇作为研究组,同期采用宫腔水囊放置治疗的38例前置胎盘剖宫产后出血孕妇作为对照组。比较两组孕妇产后24h的止血效果、手术指标(产妇控制出血时间、填塞至产后24h出血量、填塞物放置时间和住院时间),术前及术后24h的产妇血红细胞及血红蛋白浓度和术后并发症发生情况。结果产后24h,研究组孕妇的止血总有效率为100.00%,略高于对照组的94.74%,但差异无统计学意义(P>0.05);研究组孕妇的控制出血时间、填塞至产后24 h出血量、填塞物放置时间分别为(15.29±3.28)min、(80.04±10.17)mL、(28.17±1.93)h,明显少于对照组的(20.03±3.14)min、(84.19±12.04)mL、(30.08±2.47)h,差异均有统计学意义(P<0.05),而两组产妇的住院时间比较差异无统计学意义(P>0.05);两组孕妇术前红细胞、血红蛋白水平比较差异均无统计学意义(P>0.05);术后24h,两组孕妇的红细胞、血红蛋白水平均低于术前,差异均有统计学意义(P<0.05),但两组孕妇间术后24 h的红细胞、血红蛋白水平比较差异均无统计学意义(P>0.05);研究组孕妇术后并发症发生率为2.63%,略低于对照组的10.53%,但差异无统计学意义(P>0.05)。结论宫腔水囊放置术治疗前置胎盘剖宫产后出血的止血效果与宫腔球囊联合水囊放置术相似,但宫腔球囊联合水囊放置控制出血时间及填塞至产后24h出血量更少,填塞物放置时间更短,安全性均较高,临床可结合孕妇实践情况灵活选择治疗方式。Objective To explore the application effect of intrauterine balloon combined with water sac placement in patients with placenta previa bleeding after cesarean section.Methods Thirty-eight pregnant women with hemorrhage after cesarean section of placenta previa who received uterine balloon combined with water sac placement treatment in Department of Obstetrics and Gynecology,People's Hospital Puyang County from January 2019 to February 2024 were selected as the study group.At the same period,38 pregnant women with hemorrhage after cesarean section of placenta previa treated with uterine water sac placement were selected as control group.The hemostatic effect of pregnant women at 24 hours after delivery,surgical indicators(bleeding control time,bleeding volume during tamponade for 24 hours after delivery,tamponade time,and length of hospital stay),maternal blood red blood cell and hemoglobin concentration before and at 24 hours after operation,and postoperative complications were compared between the two groups.Results At 24 hours postpartum,the total effective rate of hemostasis in the study group was 100.00%,which was slightly higher than 94.74%in the control group(P>0.05).The control time of bleeding,the amount of bleeding during tamponade for 24 hours after delivery,and the tamponade time of pregnant woman in the study group were(15.29±3.28)min,(80.04±10.17)mL,and(28.17±1.93)h,which were significantly less than(20.03±3.14)min,and(84.19±12.04)mL,and(30.08±2.47)h in the control group(P<0.05).There was no significant difference in the length of hospital stay between the two groups(P>0.05).There was no significant difference in preoperative red blood cell and hemoglobin levels between the two groups(P>0.05).At 24 h after surgery,the levels of red blood cells and hemoglobin of pregnant women in two groups were significantly lower than those before surgery(P<0.05),but there was no significant difference in the levels between the two groups(P>0.05).The incidence of postoperative complications in the study group

关 键 词：前置胎盘 剖宫产 产后出血 宫腔球囊放置术 水囊放置术 

分 类 号：R719.8[医药卫生—妇产科学]