一次性球囊和阴道填塞联合腹部压迫治疗产后出血的效果

The Effect of Disposable Balloon and Vaginal Packing Combined With Abdominal Compression on Postpartum Hemorrhage

目的探讨使用一次性球囊和阴道填塞联合腹部压迫治疗产后出血(PPH)的效果。方法选取2015年1月—2017年12月宿迁市人民医院收治的235例PPH患者作为研究对象。按照入院时间的先后,将其分为两组。(1)患者使用宫内一次性球囊(对照组);(2)应用额外的阴道填塞联合腹部压迫(研究组)。评估两种方法在处理PPH的效果。结果 235例患者使用一次性球囊用于PPH,临床有效率为91.91%。研究组患者的临床有效率为94.74%(126/133),而对照组的患者的效率为88.24%(90/102)。两组患者术后并发症发生率分别为8.27%和8.82%。一次性球囊使用失败的患者中采取了子宫动脉栓塞术,没有一例导致子宫切除。结论与单独使用一次性球囊相比,宫腔内一次性球囊联合阴道填塞和腹部压迫能更有效地治疗PPH,且不增加术后并发症发生率。子宫收缩乏力与前置胎盘或植入可能会导致使用一次性球囊治疗无效。

Objective To investigate the effect of one-time balloon and vaginal packing combined with abdominal compression on postpartum hemorrhage （PPH）. Methods 235 PPH patients admitted in Suqian People＇s Hospital from January 2015 to December 2017 were selected as the research subjects. They were divided into two groups according to the time of admission. （1） The patients were treated with intrauterine disposable balloon （control group）. （2） The patients were treated with additional vaginal packing combined with abdominal compression （study group）. The effectiveness of the two methods in dealing with PPH was evaluated. Results 235 patients used a disposable balloon for PPH, and the clinical effective rate was 91.91%. The clinical effective rate of the study group was 94.74% （126/133）, while the effciency of the control group was 88.24% （90/102）. The incidence of postoperative complications in the two groups was 8.27% and 8.82%, respectively. Uterine artery embolization was performed in patients who failed to use the disposable balloon, and no case resulted in hysterectomy. Conclusion Compared with the single-use balloon alone, intrauterine disposable balloon combined with vaginal packing and abdominal compression can treat PPH more effectively without increasing the incidence of postoperative complications. Weak uterine contractions and placenta previa or implantation may result in ineffective treatment with disposable balloons.