Bakri球囊填塞术治疗瘢痕子宫二次剖宫产术产后出血临床效果分析.docVIP

Bakri球囊填塞术治疗瘢痕子宫二次剖宫产术产后出血临床效果分析 　　【摘要】 目的：探讨Bakri球囊填塞术治疗瘢痕子宫二次剖宫产术产后出血的临床效果。方法：选取2013年10月-2015年10月本院收治的瘢痕子宫分娩患者（剖宫产术中出血大于1000 mL）54例作为研究对象，根据是否应用Bakri球囊止血分为应用Bakri球囊组（A组）和未应用Bakri球囊组（B组），每组27例。比较两组产后出血原因、产后出血量、术前术后血红蛋白水平及手术相关资料。结果：A组术后血红蛋白水平高于B组，术后住院时间短于B组，差异均有统计学意义（P0.05）。结论：Bakri球囊放置操作简便，可有效治疗因瘢痕子宫行剖宫产术发生的产后出血，降低子宫切除率。 　　【关键词】 Bakri球囊； 二次剖宫产； 产后出血 　　【Abstract】 Objective：To investigate the clinical effect of Bakri balloon in the treatment of postpartum hemorrhage for patients with scar uterus second time cesarean section.Method：From October 2013 to October 2015，54 cases of scar uterus second time cesarean section that intraoperative bleeding greater than 1000 mL in our hospital were selected as the research objects，they were divided into the application of Bakri balloon group （group A） and non application of Bakri balloon group （group B） according to whether application of Bakri balloon hemostasis，each group had 27 cases.The causes of postpartum hemorrhage，the amount of postpartum hemorrhage，preoperative and postoperative hemoglobin level and operation related data of two groups were compared.Result：The postoperative hemoglobin level of group A was higher than that of group B，and the postoperative hospital stay was lower than that of group B，the differences were statistically significant（P0.05）.Conclusion：The placement of Bakri balloon is convenient and effective in treating postpartum hemorrhage of patients with second time cesarean section，which can significantly reduce the rate of hysterectomy. 　　【Key words】 Bakri balloon； Second time cesarean section； Postpartum hemorrhage 　　First-author’s address：People’s Hospital of Xingning City，Xingning 514500，China 　　doi：10.3969/j.issn.1674-4985.2016.21.030 　　产后出血是孕产妇死亡的主要原因之一，早期诊断和有效及时的处理是治疗的关键。随着近年来剖宫产率的上升，瘢痕子宫导致产后出血的发病率也逐年上升[1]。瘢痕子宫合并妊娠患者在接受剖宫产手术时容易出现产后出血，在极短时间内出血量较大甚至可以威胁产妇生命安全[2]。临床治疗瘢痕子宫二次剖宫产术产后出血的方法有按摩子宫、B-Lynch缝合术及子宫动脉结扎术等，但采用上述方法后仍不能止血，必要时需切除子宫，致使年轻女性丧失生育能力和影响生活质量[3]。Bakri球囊填塞术具有操作简单、快速、压迫面积大及易于监测止血效果的优点，