Bakri球囊治疗产后大出血的疗效分析  

Therapeutic effect of Bakri balloon tamponade on postpartum hemorrhage

作　　者：吴丽婷 陈菲菲 陈苗苗 胡娅萍 王莹[1] WU Liting;CHEN Feifei;CHEN Miaomiao;HU Yaping;WANG Ying(Department of Obstetrics,Maternal and Child Health Hospital of Hubei Province,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430070,China)

机构地区：[1]华中科技大学同济医学院附属湖北妇幼保健院产科,湖北武汉430070

出　　处：《兰州大学学报(医学版)》2025年第2期32-36,65,共6页Journal of Lanzhou University(Medical Sciences)

基　　金：湖北省自然科学基金资助项目(2022CFB561);湖北省卫生健康科研资助项目(2021SFYM021)。

摘　　要：目的探究Bakri球囊治疗在自然分娩产后严重大出血的临床效果。方法回顾性纳入华中科技大学同济医学院附属湖北妇幼保健院2016年1月—2020年12月自然分娩产后严重大出血的产妇,一线治疗失败后均给予Bakri球囊止血。收集基线和围生期结局指标,并比较Bakri球囊止血失败和止血成功产妇、胎盘植入与非胎盘植入产妇的临床围生期结局。结果纳入的170例自然分娩产后严重大出血产妇,胎盘植入产妇占比51.8%(88/170),Bakri球囊止血成功率为87.7%(149/170);而胎盘植入产妇止血有效率显著低于非胎盘植入产妇(χ^(2)=5.73,P=0.017)。与止血失败产妇相比,止血成功产妇Bakri球囊填塞术前出血量、术后出血量、输血比例较低,填塞术间隔时间、球囊置留时间较长(均P<0.05)。胎盘植入是影响Bakri球囊止血成功的高风险因素(OR=6.569,95%CI:[1.454,18.751])。结论胎盘植入是引起自然分娩产后大出血的主要原因,应用Bakri球囊对不伴有胎盘植入的产后出血有效,但对伴有胎盘植入的产后出血,止血失败风险增加。Objective To explore the maternal outcomes of Bakri balloon tamponade(BBT)in the treatment of severe postpartum hemorrhage(sPPH).Methods Women presenting with sPPH after natural childbirth were retrospectively included in Maternal and Child Health Hospital of Hubei Province,Tongji Medical College,Huazhong University of Science and Technology from January 2016 to December 2020.All eligible women were given BBT treatment after failed first-line treatment.The clinical baseline characteristics,perinatal outcomes between women with Bakri success and Bakri failure,women with placenta accreta and without placenta accreta were collected and analyzed.Results Among the 170 women selected,placental implantation accounted for 51.8%(88/170)and BBT showed an effectiveness of 87.7%(149/170).Women with placenta accrete had a lower BBT success rate than those without placenta accrete(χ^(2)=5.73,P=0.017).Compared to women with BBT failure,women with BBT success had a significantly reduced pre/post-BBT blood loss,low need for blood transfusion,a prolonged duration from delivery to balloon placement,a prolonged balloon retention time(all P<0.05).Placenta accrete is a high-risk factor for BBT success in sPPH treatment(OR=6.569,95%CI:[1.454,18.751]).Conclusion Placenta accrete is the main cause of sPPH in natural childbirth.The use of BBT is effective for sPPH in women without placenta accrete,but increases the risk of hemostasis failure in women with placenta accrete.

关 键 词：胎盘植入 严重大出血 Bakri球囊 自然分娩 临床效果 

分 类 号：R714.7[医药卫生—妇产科学]