阴道塞纱术及球囊填塞术在防治产后出血中的应用

THE APPLICATION OF INTRAVIAGINAL YARN PLUGGING AND BAKRI BALLOON FOR PREVENTION AND TREATMENT OF POSTPARTUM HEMORRHAGE

目的 研究阴道塞纱术及球囊填塞术在防治产后出血中的应用,探讨如何降低产科子宫切除率.方法 回顾性分析两年内在我院分娩的16 164名孕产妇病例资料,以2012年2月～2013年1月间在我院分娩的孕产妇为对照组,2013年2月～ 2014年1月在我院分娩的孕产妇为研究组,分析两组孕产妇中严重高危孕产妇分娩数、产后出血发生率、产科急诊子宫切除率、阴道塞纱率、Bakri球囊填塞术发生率等内容.结果 研究组中产科子宫切除率及产后出血发生率均明显低于对照组,差异均有统计学意义,（x2值分别为3.27、17.02,p值分别为0.039、0.000）,（p ＜0.005）;研究组中阴道塞纱率明显高于对照组,差异有统计学意义（x2 =675.21,p=0.000）;研究组中Bakri球囊使用率明显高于对照组,差异有统计学意义（x2=40.21,p=0.000）.结论 阴道塞纱术可降低产后出血率;阴道塞纱术及Bakri球囊填塞术均可降低产科急诊子宫切除率.

Objective To research the application of intravaginal yarn plugging and Bakri balloon in prevention and treatment of postpartum hemorrhae; discuss how to reduce the incidence of obstetrical emergency hysterectomy. Methods Retrospectively analyzed 16164 delivery history in our hospital in nearly two years. Take the patients from February 2012 to January 2013 as control group, the patients from February 2013 to January 2014 as research group, compare the severe dangerous deliveries, the postpartum hemorrhage incidence, the incidence of obstetrical emergency hysterectomy, vagina plugging yarn rate and plugging Bakri balloon rate in the two groups. Results The incidence of the emergency obstetric hysterectomy and the rate of postpartum hemorrhage in 2013 were both obviously lower than control group, （χ^2 =3.27,17.02,p =0. 039,0. 000） ; The using of plugging the yarn in vagina was significantly higher than in the control group, （χ^2 = 675.21 ,p = O. 000 ） ;The usage rate of Bakri balloon in research group was significantly higher than in the control group, （ χ^2 = 40. 21 ,p = 0. 000）. Conclusion Firstly, the using of plugging the yarn in vagina could reduce the incidence of postpartum hemorrhage rate; Secondly, using Bakri balloon combined with reducing the rate of postpartum hemorrhage can reduce the incidence of obstetrical emergency hysterectomy.