Bakri球囊联合子宫动脉结扎在凶险性前置胎盘产后出血中的应用研究  

Application of Bakri Balloon and Uterine Artery Ligation in Postpartum Hemorrhage of Fierce Placenta Previa

作　　者：叶桂芳 姜艳艳[1] 尹才芳 伦思敏 纪晓丽 Ye Guifang;Jiang Yanyan;Yin Caifang(Department of Obstetrics,Houjie Hospital,Dongguan,Guangdong,523000,China)

机构地区：[1]东莞市厚街医院产科,广东东莞523000

出　　处：《黑龙江医学》2024年第22期2719-2721,共3页Heilongjiang Medical Journal

基　　金：2022年东莞市社会发展科技项目(20221800903882)。

摘　　要：目的:探讨Bakri球囊联合子宫动脉结扎在凶险性前置胎盘产后出血(PPH)中的应用效果,以期为临床手术方案的选择提供参考。方法:选取2020年1月—2023年4月东莞市厚街医院收治的60例凶险性前置胎盘患者作为研究对象,按照手术方式不同进行分组,分为观察组和对照组,每组各30例。对照组采用常规子宫动脉上行支结扎、8字缝合、宫腔填塞、B-Lynch缝合治疗,观察组采用Bakri球囊联合子宫动脉结扎进行治疗。对比两组患者手术相关指标、出血情况、凝血功能以及术后并发症(产褥感染、子宫切除、瘢痕憩室发生率)发生情况。结果:观察组手术用时较对照组短,差异有统计学意义(t=11.365,P<0.05);观察组患者术中出血量、术后24 h出血量均显著少于对照组,差异有统计学意义(t=18.664、14.898,P<0.05);两组患者凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)比较,差异无统计学意义(t=1.916、0.754,P>0.05);两组患者术后并发症发生率比较,差异无统计学意义(χ^(2)=0.144,P>0.05)。结论:Bakri球囊联合子宫动脉结扎应用于凶险性前置胎盘PPH患者中可以缩短手术时间,减少出血量,对凝血功能影响较小,不会增加并发症发生率。Objective:To explore the application effect of Bakri balloon(IBBT)and uterine artery ligation in the postpartum hemorrhage of dangerous placenta previa(PPH),and to provide a reference for the selection of clinical surgical options.Methods:60 patients with dangerous placenta previa treated in Houjie Hospital of Dongguan City from January 2020 to April 2023 were selected as the study objects.According to different surgical methods,they were divided into observation group and control group,with 30 cases in each group.The control group was treated with conventional ascending branch of uterine artery ligation,figure-8 suture,uterine tamponade and B-Lynch suture,while the observation group was treated with Bakri balloon combined with uterine artery ligation.Operation-related indexes,bleeding,coagulation function and postoperative complications(puerperal infection,hysterectomy and cicatricial diverticulum)were compared between the two groups.Results:The operation time of the observation group was less than that of the control group,and the difference was statistically significant(t=11.365,P<0.05).The intraoperative blood loss and 24 h postoperative blood loss in the observation group were significantly lower than those in the control group,with statistically significant difference(t=18.664,14.898;P<0.05).There was no significant difference in PT and APTT between the two groups(t=1.916,0.754;P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(χ^(2)=0.144,P>0.05).Conclusion:Bakri balloon combined with uterine artery ligation in patients with PPH can reduce the operation time,reduce the amount of bleeding,and have little impact on coagulation function.It will not increase the incidence of complications.

关 键 词：Bakri球囊 子宫动脉结扎 凶险性前置胎盘 产后出血 

分 类 号：R713.4[医药卫生—妇产科学]