Bakri子宫填塞球囊导管联合卡前列素氨丁三醇用于治疗前置胎盘出血的临床研究

The clinical analysis of the application of Bakri tamponadeuterine balloon catheter combined with carboprost tromethamine injection in placenta previa bleeding

目的探讨Bakri子宫填塞球囊导管联合卡前列素氨丁三醇在前置胎盘出血中的应用效果。方法前置胎盘孕妇52例,其中凶险型前置胎盘6例,完全性前置胎盘14例,部分性前置胎盘20例,边缘性前置胎盘12例,均为剖宫产分娩。孕妇随机分成两组：研究组26例,给予Bakri子宫填塞球囊导管联合卡前列素氨丁三醇治疗;对照组26例,给予局部多点缝扎止血联合卡前列素氨丁三醇进行治疗。比较两组年龄、分娩孕周、既往分娩次数、既往剖宫产次数、手术时间、治疗后出血量、术后白细胞、体温、住院时间、住院费用及子宫切除等情况。结果两组患者年龄、分娩孕周、既往分娩次数、既往剖宫产次数差异无统计学意义（P〉0.05）,而研究组手术时间、治疗后出血量、术后白细胞、体温、住院时间明显低于对照组,差异有统计学意义（P〈0.05）。研究组中无一例切除子宫,取出球囊后无一例再发出血,所有患者无明显疼痛,无产后发热,均住院7~9 d痊愈出院。对照组中3例凶险型前置胎盘因治疗无效,再次开腹行子宫次全切除术。结论 Bakri子宫填塞球囊导管联合卡前列素氨丁三醇适用于前置胎盘出血增多,止血方便、快捷、迅速,但要适当选择治疗时机,早期干预。

Objective To study the effect of the Bakri tamponadeuterine balloon catheter combined with carboprost tromethamine injection in placenta previa bleeding.Methods The clinical data of 52 cases pregnant women with placenta previa from January 2012 to December 2014 were analyzed.Of which,6 cases were dangerous type of placenta previa,14 cases were complete placenta previa,20 cases were partial placenta previa,and 12 cases were marginal placenta previa.In the study group,26 patients were given Bakri tamponadeuterine balloon catheter combined with carboprost tromethamine injection treatment.And the other 26 cases,control group,received the treatment of local suture bleeding and carboprost tromethamine injection.The age,gestational weeks,delivery times,history of prior cesarean,operation time,the amount of bleeding after treatment,postoperative leukocyte,body temperature,hospitalization expenses,hysterectomy,and hospitalization time of two groups were compared.Results The differences have no statistical significance in age,gestational weeks,delivery times,and history of previous cesarean section between two groups（P〉 0.05）.The operation time,bleeding volume,postoperative leukocyte count,temperature,and time in hospital of study group were significantly lower than those of the control group（P〈0.05）.In the study group,there were no cases of hysterectomy,no cases of recurrent hemorrhage after taking out the balloon,all patients had no significant pain,no postpartum fever,and were cured and discharged from hospital in 7~9 days.In the control group,3 cases of dangerous placenta praevia needed one more time of subtotal hysterectomy.Conclusion Bakri tamponadeuterine balloon catheter combined with carboprost tromethamine Injection is suitable for treating placenta previa.It is convenient and quick,but need early intervention.