前置胎盘剖宫产术中两种止血方法的应用比较

Comparison of application of two hemostasis ways in placenta previa cesarean section

目的探讨在前置胎盘剖宫产术中使用Bakri子宫球囊填塞和宫腔塞纱两种止血方法的临床疗效。方法对114例行剖宫产的前置胎盘患者进行回顾性研究,其中66例术中使用Bakri子宫填塞球囊导管患者为Bakri组,48例使用宫腔塞纱患者为宫腔塞纱组,比较两组术后24 h出血量、止血成功率、手术时间、是否需急诊手术、子宫切除率、产褥病发生率、住院时间等。结果两组患者术后24 h出血量、止血成功率、急诊手术比例及住院时间比较差异无统计学意义(P>0.05)。Bakri组产褥病发生率低于宫腔塞纱组,但差异无统计学意义(P>0.05)。Bakri组手术时间为(55.4±9.1)min,短于宫腔塞纱组的(58.8±8.5)min,差异有统计学意义(P<0.05)。两组均无子宫切除病例。结论 Bakri子宫腔球囊填塞和宫腔塞纱均可作为前置胎盘剖宫产中的保守性治疗措施,止血疗效肯定,并发症少,可根据医院和患者的具体情况选择使用。

Objective To investigate clinical effects by two hemostasis ways, as Bakri uterine balloon packing and uterine cavity gauze packing, in placenta previa cesarean section. Methods A total of 114 patients with placenta previa receiving cesarean section were taken into retrospective research. There were 66 cases as Bakri group receiving Bakri uterine balloon packing in operation, and 48 cases as uterine cavity gauze packinggroup receiving uterine cavity gauze packing in operation. Comparison was made on 24 h postoperative bleeding volume, hemostasis success rate, operation time, emergency operation requirement, hysterectomy rate, incidence of puerperalism, and hospital stay time between the two groups. Results There was no statistically significant difference of 24 h postoperative bleeding volume, hemostasis success rate, emergency operation proportion and hospital stay time between the two groups（P〉0.05）. The Bakri group had lower incidence of puerperalism than the uterine cavity gauze packing group, but their difference had no statistical significance（P〉0.05）. The Bakri group had shorter operation time as（55.4±9.1） min than（58.8±8.5） min in the uterine cavity gauze packing group, and their difference had statistical significance（P〈0.05）. There was no hysterectomy case in both groups. Conclusion Both of Bakri uterine balloon packing and uterine cavity gauze packing can act as conservative treatment measures in placenta previa cesarean section, along with affirmative hemostasis effect and few complications. Selection can be made in accordance with practical situation of hospital and patients.