宫腔Bakri球囊填塞、B-Lynch缝合和纱条填塞在预防和治疗产后出血中的效果对比

Effect comparison of uterine cavity Bakri balloon tamponade,B-Lynch suture and gauze packing in the prevention and treatment of postpartum hemorrhage

目的研究产后出血患者使用宫腔Bakri球囊填塞、B-Lynch缝合和纱条填塞这三种措施的效果。方法将2014年1月~2015年12月在我院接受治疗的133例患者产后出血患者作为研究对象,其中57例给予宫腔Bakri球囊填塞止血,42例给予B-Lynch缝合止血,34例给予纱条填塞止血。比较三种止血措施的效果,分析止血效果与高危因素的关系。结果 Bakri球囊填塞组止血成功率为91.22%,B-Lynch缝合组止血成功率为92.85%,纱条填塞组止血成功率为91.17%,三组间比较差异无统计学意义(P>0.05)。三组患者手术时间、子宫复旧及产后感染情况三组间比较差异无统计学意义(P>0.05)。Bakri球囊填塞组手术时间显著短于其他两组,三组间比较差异有统计学意义(P<0.05)。子宫因素与胎盘因素同时存在时,患者止血失败率最高(P<0.05)。结论三种止血方式止血成功率差异无统计学意义,但是Bakri球囊填塞可显著降低患者手术时间,为患者治疗争取时间。子宫因素与胎盘因素同时存在时,患者止血失败率最高,故在治疗中应预见性地采取相应措施令患者产后出血量减少,从而降低围产期孕妇病死率。

Objective To study the effect of uterine cavity Bakri balloon tamponade,B-Lynch suture and gauze packing of postpartum hemorrhage patients. Methods 133 patients with postpartum hemorrhage Cured in our hospital from January 2014 to December 2015 were selected as the study objects.Among them,57 cases were treated with uterine cavity Bakri balloon tamponade,42 cases were treated with B-Lynch suture,34 cases were treated with gauze packing.Effects of three hemostatic measures were compared.And relationship between hemostatic effect and risk factors were compared. Results The success rate of hemostasis of uterine cavity Bakri balloon tamponacte was 91.22%,the success rate Of hemostasis of B-Lynch suture was 92.85%,the success rate of hemostasis of gauze packing was 91.17%,and there was no Significance between the three groups（P〉 0.05）.There was no significant difference on operation time,postpartum uterine involution and infection of uterine cavity Bakri balloon tamponade was significantly between the three groups（P 〉 0.05）.The operation time shorter than the other two groups,there was significant difference between the three groups （P 〈 0.05）.The failure rate of hemostasis was the highest（P 〈 0.05） in the presence of uterine and placental factors. Conclusion There was no significant difference in success rate between the three methods of hemostasis.But uterine cavity Bakri balloon tamponade can significantly reduce the operation time,to buy time for the patients.When the factors of uterus and placenta are present,the failure rate is highest.Therefore,the corresponding measures should be taken to reduce the amount of postpartum hemorrhage in the treatment,so as to reduce the mortality rate of perinata｜ pregnant women.