应用子宫填塞球囊导管治疗产后出血的初步经验

Application of uterine tamponade with balloon catheter for treatment of postpartum hemorrhage

目的探讨应用子宫填塞球囊导管治疗产后出血的疗效及安全性。方法对我院2010年1月-2012年2月，24例使用子宫填塞球囊导管治疗产后出血患者进行回顾性分析。患者年龄22～34岁，平均27．5岁，其中产后出血病因宫缩乏力12例、前置胎盘4例，胎盘粘连8例。结果全部病例均能应用子宫填塞球囊导管达到止血目的，无一例行子宫切除术。一次止血有效率达91．6％。2例患者出现再发出血，再次充盈气囊止血后，两例患者于24小时再尝试取出水囊，未再发大出血，总止血有效率达100％。无一例需行子宫切除术或死亡，术后随访1．24个月，24例均能正常子宫复旧，恢复月经时间1—3个月，无一例出现产褥期感染，及卵巢早衰症状。结论应用子宫填塞球囊导管治疗产后出血是一种安全、有效的治疗方式，值得临床推广应用。

Objective To investigate the efficacy and safety of uterine tamponade with balloon catheter for the treatment of postpartum hemorrhage. Methods The data on 24 patients with postpartum hemorrhage who had received uterine tamponade with balloon catheter during the period of January 2010 to February 2012 were retrospectively analyzed. The average age of the patients was 27.5 years old （ 22-34 ）. Of the 24 patients, 12 had uterine inertia, 4 had placenta previa, and 8 had placenta accrete. Results All the patients were cured by uterine tamponade with balloon catheter, and no one needed to undergo hysterectomy. The primary effectiveness rate of hemostasis was 91.6%. Two patients had rebleeding, and the tamponade balloon was inflated again to stop bleeding. The tamponade balloon was removed after 24 hours. None had rebleeding, nor hysterectomy needed. The total effectiveness rate of hemostasis was 100%. No patients required hysterectomy or were dead. All the patients were followed up for 1 to 24 months postoperatively and had a normal uterine involution and menstrual restoration within 1 to 3 months. No puerperal infection or symptoms of premature ovarian failure occurred. Conclusions Application of uterine tamponade with balloon catheter in the treatment of postpartum hemorrhage is safe, effective, and worth popularizing clinically.