Bakri球囊填塞联合超选择子宫动脉栓塞在难治性产后出血的应用效果

Application Effect of Bakri Balloon Tamponade Combined with Superselective Uterine Artery Embolization in the Treatment of Intractable Postpartum Hemorrhage

目的:探究Bakri球囊填塞联合超选择子宫动脉栓塞在难治性产后出血的应用效果。方法:选取2013年7月~2017年7月难治性产后出血患者96例,按止血方式分为对照组和联合组各48例,对照组行Bakri球囊填塞,联合组在对照组基础上联合超选择子宫动脉栓塞术,观察比较两组止血情况、术中情况、产前产后凝血功能指标及术后并发症。结果:联合组止血成功46例,明显高于对照组的40例(P<0.05),联合组术中出血量显著低于对照组(P<0.05),两组术中收缩压、舒张压及心率比较差异无统计学意义(P>0.05)。联合组PT、APTT、TT水平显著低于对照组(P<0.05),FIB水平显著高于对照组(P<0.05),两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论:Bakri球囊填塞联合超选择子宫动脉栓塞在难治性产后出血止血效果确切,能有效稳定患者凝血功能,且安全性较好。

Objective:To explore the effect of Bakri balloon tamponade combined with superselective uterine artery embolization in the treatment of intractable postpartum hemorrhage.Methods:A total of 96 patients with intractable postpartum hemorrhage from July 2013 to July 2017 were selected and divided into control group and combination group according to the methods of hemostasis,with 48 cases in each group.The control group was given Bakri balloon tamponade treatment,and the combination group was given superselective uterine artery embolization treatment on the basis of control group,then the hemostasis,intraoperative conditions,pre natal and postpartum coagulation function,and the postoperative complications in the two groups were observed and compared.Results:There were 46 cases of hemostasis in the combined group,which was significantly higher than that of the control group of 40 cases(P<0.05).The bleeding volume in combination group was significantly lower than that in control group(P<0.05).There was no significant difference in systolic blood pressure,diastolic blood pressure and heart rate between the two groups(P >0.05).The levels of PT,APTT,TT in combination group were significantly lower than those in control group(P<0.05)while the level of FIB was significantly higher than that of control group.(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P >0.05).Conclusion:Bakri balloon tamponade combined with superselective uterine artery embolization has good effet in the treatment of intractable postpartum hemorrhage,which can effectively stabilize the blood coagulation function with good safety.