宫腔球囊在产妇剖宫产术后出血中的临床疗效分析

Therapeutic effect of intrauterine balloon on postpartum hemorrhage after cesarean section

目的探讨宫腔球囊在产妇剖宫产术后出血中的临床疗效。方法选取2018年12月至2019年11月在平煤医疗集团总医院行剖宫产术后出血的40例患者作为研究对象,采用随机数字表法分为观察组和对照组,每组20例。对照组给予宫腔内填塞纱布压迫法止血,观察组给予宫腔球囊压迫法止血。观察并记录两组输血量、不同时刻出血量(术中及术后2 h)、彻底止血时间、手术时间、止血成功率、住院时间和随访3个月的并发症发生情况。结果观察组输血量、术中及术后2 h出血量优于对照组(P<0.05);观察组彻底止血时间、手术时长及术后住院时长优于对照组(P<0.05);观察组止血成功率为95%(19/20),对照组为90%(18/20),两组止血成功率比较,差异无统计学意义(P>0.05);观察组无感染发生,对照组并发症发生率为25%(5/20),两组感染并发症发生率比较,差异有统计学意义(χ~2=4.597, P=0.029)。结论宫腔球囊止血快速、操作简单,疗效确切,适用有产后出血倾向和出血发生的产妇。放置球囊后应密切监护,若后续出血仍然较多,分析出血原因后可考虑其他的止血方式。

【Objective】 To investigate the efficacy of intrauterine balloon in postpartum hemorrhage after cesarean section.【Methods】Forty patients with postpartum hemorrhage after cesarean section diagnosed and treated in our hospital from December2018 to November 2019 were randomly divided into observation group(n=20) and control group(n=20). The control group was given intrauterine gauze compression method to stop bleeding, while the observation group was treated with intrauterine balloon compression for hemostasis. The blood transfusion volume, blood loss at different times(during operation and 2 hours after operation), complete hemostasis time, operation time, hemostasis success rate, the hospitalization time, and the incidence of complications with 3 months of follow-up were observed and recorded. 【Results】The blood transfusion volume, blood loss during operation and 2 hours after operation of the observation group were significantly less than those of the control group(P<0.05). Complete hemostasis time, operation time and the length of postoperative hospitalization of the observation group were significantly shorter than those of the control group(P<0.05). The success rate of hemostasis was 95%(19/20) in the observation group and 90%(18/20)in the control group, and there was no significant difference between the two groups(P>0.05). There was no infection in the observation group. The incidence of complications in the control group was 25%(5/20), and the difference between the two groups was statistically significant(χ~2=4.597, P=0.029).【Conclusion】The uterine balloon can stop bleeding quickly, it is easy to operate,and satisfactory in efficacy. It should be actively used in patients with postpartum bleeding tendency and postpartum hemorrhage.After the balloon is placed, it should be closely monitored. If there is still a lot of bleeding in the follow-up, other methods of hemostasis may be considered after analyzing the cause of the bleeding.