Foleys双腔导尿管填塞宫腔治疗产后出血的临床研究

Clinical research of Foleys double-lumen catheter tamponade intrauterine in the treatment of postpartum hemorrhage

目的探讨Foleys双腔导尿管填塞宫腔治疗宫缩乏力性产后出血的疗效。方法选择2009年1月至2012年6月在我院分娩并出现宫缩乏力的产妇85例,其中采用Foleys双腔导尿管填塞治疗48例,采用纱布宫腔内填塞治疗37例,观察两组患者的放置时间、出血量、产褥感染率。结果 Foleys双腔导尿管组放置时间与止血时间明显短于宫腔内塞纱组,差异有统计学意义(P<0.01);Foleys双腔导尿管组术中出血量与宫内塞纱组比较差异有统计学意义(P<0.05);两组患者的止血有效率分别为93.75%与91.89%,差异无统计学意义(P>0.05)。两组术后24h的总出血量与填塞物留置时间差异无统计学意义;Foleys组的产褥感染率为2.08%,宫内塞纱组为5.41%,宫内塞纱的住院时间长于Foleys组,两项指标相比差异有统计学意义(P<0.05);宫内塞纱组的取出填塞物后的再出血率高于Foleys双腔导尿管组,差异具有统计学意义(P<0.01)。结论 Foleys双腔导尿管用于填塞宫腔治疗宫缩乏力性产后出血简单快速且效果明显,值得基层医院推广。

Objective To explore the clinical effects of Foleys double-lumen catheter tamponade intra- uterine in the treatment of postpartum hemorrhage after uterine inertia. Methods Eighty-five patients with post- natal uterine inertia in our hospital from January 2009 to June 2012 were randomly divided into two groups： group A （n=48, treated by Foleys double-lumen catheter tamponade intrauterine） and group B （n=37, treated by gauze intrauterine tamponade）. The storage time, amount of bleeding, and the rate of puerperal infection were compared between the two groups. Results Storage time and time to stop bleeding of group A were significantly shorter than those of group B （P〈0.01）. The blood loss of the two group showed statistically significant difference （P〈 0.05）. The rate of hemostatic was 93.75% in group A and 91.89 in group B, with no statistically significant difference between the two groups （P〉0.05）. The total amount of bleeding after 24 h and stuffing indwelling time had no statisti- cally significant difference between the two groups. The rate of puerperal infection was 2.08% in group A, significant- ly lower than that in group B （5.41%）. The length of hospital stay of group A were significantly shorter than that of group B （P〈0.05）. The rate of rebleeding in group A was significantly lower than that of group B. Conclusion For treating postpartum hemorrhage after uterine inertia, Foleys double-lumen catheter tamponading uterine has advantag- es of simple, fast, and obvious effect, which could be spread in primary hospitals.