Bakri子宫填塞球囊导管治疗剖宫产术中出血的安全性

Safety of Bakri Uterine Tamponade Balloon Catheter in Treatment of Hemorrhage during Cesarean Section

目的探讨Bakri子宫填塞球囊导管(简称Bakri球囊)治疗剖宫产术中出血的安全性,并总结应用经验。方法回顾性分析166例行剖宫产分娩孕妇的临床资料,以是否使用Bakri球囊进行分组:研究组(使用Bakri球囊者)81例,对照组(未使用Bakri球囊者)85例。比较2组术中出血量,产后24 h出血量,术后体温、白细胞数(WBC)、降钙素原(PCT),使用抗生素类型,是否升级使用抗生素,产后恢复情况等。结果2组术后WBC、PCT比较差异无统计学意义(P>0.05),对照组术后体温低于研究组[(36.91±0.39)℃比(37.15±0.60)℃,P<0.05]。研究组中产后出血(产后24 h出血量≥1000 mL,n=35)与非产后出血者(产后24 h出血量<1000 mL,n=46)术前术后体温及术前WBC比较,差异无统计学意义(P>0.05);与非产后出血者比较,产后出血者术后的WBC更高[(16.96±5.28)×10^9 L^-1比(13.88±3.89)×10^9 L^-1,P<0.05],PCT更低[0.06(0.04,0.26)ng·mL^-1比0.07(0.04,0.06)ng·mL^-1,P<0.05];升级使用和未升级使用抗生素者比较,术后体温、白细胞数及PCT比较差异无统计学意义(P>0.05)。2组术后恶露持续时间与月经恢复情况比较差异无统计学意义(P>0.05)。结论Bakri球囊填塞作为一种预防和治疗产后出血的方式,方便快捷、安全有效,虽会引起体温升高,但并不增加产褥感染的发生率。

Objective To investigate the safety of Bakri uterine tamponade balloon catheter(Bakri balloon)in the treatment of hemorrhage during cesarean section and to summarize the application experience.Methods Clinical data of 166 pregnant women undergoing cesarean delivery were retrospectively analyzed.These women were divided into two groups:study group(Bakri balloon was used in 81 women)and control group(Bakri balloon was not used in 85 women).Intraoperative blood loss,24-hour postpartum blood loss,postoperative body temperature,white blood cell count(WBC),procalcitonin(PCT),antibiotic use and postpartum recovery were compared between the two groups Results There were no significant differences in WBC and PCT between the two groups(P>0.05).The postoperative body temperature in control group was lower than that in study group((36.91±0.39)℃vs(37.15±0.60)℃,P<0.05).The preoperative and postoperative body temperature and preoperative WBC were not different between women with postpartum hemorrhage(24-hour postpartum blood loss≥1000 mL,n=35)and women without postpartum hemorrhage(24-hour postpartum blood loss<1000 mL,n=46)(P>0.05).However,postoperative WBC in women with postpartum hemorrhage was higher than that in women without postpartum hemorrhage((16.96±5.28)×10^9 L^-1 vs(13.88±3.89)×10^9 L^-1,P<0.05),and PCT level in women with postpartum hemorrhage was lower than that in women without postpartum hemorrhage(0.06(0.04,0.26)ng·mL vs 0.07(0.04,0.06)ng·mL,P<0.05).No significant differences were found in postoperative body temperature,WBC and PCT level between patients who were treated with upgraded antibiotics and patients who used un-upgraded antibiotics(P>0.05).In addition,there were no significant differences in lochia duration and menstrual recovery between the two groups(P>0.05).Conclusion Bakri balloon tamponade is a convenient,fast,safe and effective way to prevent and treat postpartum hemorrhage.Although it may cause a rise in body temperature,it does not increase the incidence of postpartum infections.