Abstract:Objective To study the therapeutic effect of balloon tamponade in the treatment of postpartum hemorrhage of the lower uterine segment. Methods From October 2015 to October 2017, in Wuxi Maternal and Child Health Hospital, 60 patients with postpartum hemorrhage of the lower uterine segment were selected, according to random number table method, they were divided into observation group and control group, with 30 cases in each group. The control group received Oxytocin+Carboprost tromethamine intrauterine injection therapy, the observation group received balloon tamponade treatment based on the control group. The general condition, hemostasis effect, perioperative blood loss, postoperative recovery, postoperative complications of two groups were recorded and compared. Results The hemostatic effect in observation group was better than control group, the difference was statistically significant (P < 0.05). The blood loss during the operation, 2 h after operation, 24 h after operation in observation group were lower than control group, the differences were statistically significant (P < 0.01). The abnormal temperature time, menstrual recovery time and blood lochia time in observation group were significantly less than control group, the differences were statistically significant (P < 0.01). Incidence of adverse reactions in observation group was less than control group, the difference was statistically significant (P < 0.05). Conclusion The balloon tamponade can be used in treatment of postpartum hemorrhage of lower uterine segment by improving the hemostatic effect, it is worthy of clinical application.
邹金芳 张霞 李小丹. 球囊填塞治疗剖宫产子宫下段出血的有效性[J]. 中国医药导报, 2019, 16(5): 88-91.
ZOU Jinfang ZHANG Xia LI Xiaodan. Effectiveness of the balloon tamponade in treatment of postpartum hemorrhage of lower uterine segment. 中国医药导报, 2019, 16(5): 88-91.
[1] 付晨薇,刘俊涛,杨剑秋,等.子宫填塞球囊导管治疗产后出血的临床效果[J].协和医学杂志,2013,4(1):31-34.
[2] Kim JE,So YH,Kim BJ,et al. Postpartum hemorrhage from non-uterine arteries: clinical importance of their detection and the results of selective embolization [J]. Acta radiologica,2018,59(8):932-938.
[3] Bai J,Sun Q,Zhai H. A comparison of oxytocin and carboprost tromethamine in the prevention of postpartum hemorrhage in high-risk patients undergoing cesarean delivery [J]. Exp Ther Med,2014,7(1):46-50.
[4] 余琼.卡前列素氨丁三醇注射液对前置胎盘剖宫产产后出血的预防作用观察[J].中医临床研究,2018,10(12):135-136.
[5] 尹恒,肖梅.BAKRI球囊治疗产后出血在妇幼保健机构中的应用[J].公共卫生与预防医学,2013,24(4):116-117.
[6] 曾成英,万波,郭遂群,等.Bakri球囊填塞与B-Lynch缝合治疗剖宫产术产后出血的疗效比较[J].实用妇产科杂志,2016,32(6):472-474.
[7] 郭东晓,张淑一.妇产科出血性疾病的中西医诊断与治疗[M].兰州:兰州大学出版社,2009:135-140.
[8] 陈羡丽.多产产妇产后出血的危险因素及护理[J].按摩与康复医学,2018,9(14):72-73.
[9] 周丽.产后出血高危因素分布及出血原因分析[J].中国卫生标准管理,2018,9(11):37-40.
[10] 龚英.产后出血的预防与急救探讨[J].中国社区医师,2018,34(17):50,52.
[11] 刘兴会,陈锰.全球产后出血指南异同[J].中国实用妇科与产科杂志,2017,33(6):556-559.
[12] 刘兴会,张力,张静.《产后出血预防与处理指南(草案)》(2009)及《产后出血预防与处理指南(2014年版)》解读[J].中华妇幼临床医学杂志:电子版,2015,11(4):433-447.
[13] 刘兴会,陈锰.产后出血与孕产妇死亡[J].中国实用妇科与产科杂志,2014,30(4):241-243.
[14] 吴金秀.卡前列素氨丁三醇应用于高危妊娠产后出血的临床效果分析[J].实用妇科内分泌杂志:电子版,2018, 5(10):16-17.
[15] 陈怡.卡前列素氨丁三醇、麦角新碱、缩宫素三联疗法预防产后出血的临床疗效观察[J].中国妇幼保健,2018, 33(6):1266-1268.
[16] 李春梅.宫体注射卡前列素氨丁三醇对剖宫产产后出血的预防效果[J].河南医学研究,2018,27(1):131-132.
[17] Kong CW,To WW. Prognostic factors for the use of intrauterine balloon tamponade in the management of severe postpartum hemorrhage [J]. Int J Gynaecol Obstet,2018,142(1):48-53.
[18] Seidel V,Braun T,Weizs?覿cker K,et al. Application of chitosan-covered gauze in combination with intrauterine balloon tamponade for postpartum hemorrhage treatment—case report of a novel “uterine sandwich” approach [J]. Int J Surg Case Rep,2018,48(1):101-103.
[19] Guo Y,Hua R,Bian S,et al. Intrauterine Bakri balloon and vaginal tamponade combined with abdominal compression for the management of postpartum hemorrhage [J]. J Obstet Gynaecol Can,2018,40(5):561-565.
[20] 赵小凤,孙晓峰,丘文君,等.Bakri球囊与宫腔纱条填塞术在防治前置胎盘产后出血中的比较[J].右江医学,2015,43(6):711-714.
[21] 王瑜,兰志勋,杨年,等.腹主动脉球囊阻断联合宫腔填塞预防前置胎盘产后出血[J].四川医学,2016,37(7):752-754.
[22] 梁亚霞,梁燕.Bakri子宫填塞球囊导管相对常规纱布填塞在产后出血中应用效果及安全性[J].中国实用医药,2017,12(17):96-97.