Bakri球囊填塞治疗剖宫产产后出血效果及对凝血功能影响

The clinical effect of Bakri balloon packing for treating postpartum hemorrhage after cesarean section and its effect on coagulation function

目的:分析Bakri球囊填塞治疗剖宫产产后出血疗效及对凝血功能的影响。方法:收集2017年6月-2020年6月在本院妇产科剖宫产产后出血的60例患者临床资料,根据剖宫产后出血原因及止血方案的不同,将患者分为Bakri球囊填塞(球囊组)和B-lynch缝合法(缝合组)各30例。比较两组围术期指标、止血效果及并发症情况,以及术前术后血流指标、凝血功能指标等。结果:球囊组手术时间(63.7±13.2min)、术中出血量(314.3±50.2ml)、输血量(1.5±0.3U)、术后2h出血量(124.7±20.1ml)、术后24h出血量(867.5±78.9 ml)及住院时间(5.0±1.5d)均低于缝合组(P<0.05),止血成功率球囊组与缝合组(93.3%、86.7%)无差异(P>0.05),术后并发症发生率球囊组(10.0%)低于缝合组(36.8%)(P<0.05);术后两组心率、舒张压、收缩压等血流指标均高于术前但球囊组低于缝合组,两组凝血酶原时间、活化部分凝血酶原时间均低于术前,纤维蛋白原水平高于术前且球囊组变化幅度高于缝合组(均P<0.05)。结论:Bakri球囊填塞治疗剖宫产产后出血疗效优于B-lynch缝合法,Bakri球囊填塞操作简单、节省时间,更利于降低手术时间、提高止血效率以及改善产妇血流指标及凝血功能。

Objective:To analyze the clinical effect of Bakri balloon packing for treating postpartum hemorrhage of women after cesarean section,and to study its effect on their coagulation function.Methods:The clinical data of 60 women with postpartum hemorrhage after cesarean section from June 2017 to June 2020 were collected.According to the cause of bleeding and the different hemostatic treatments,the women were divided into group A(30 women given Bakri balls packing)and group B(30 women given B-lynch suture).The perioperative indicators,hemostatic effects,and complications rate,as well as the blood flow indicators,and coagulation function indicators of the women were compared between the two groups.Results:The operative time(63.7±13.2min),intraoperative blood loss(314.3±50.2ml),blood transfusion volume(1.5±0.3U),blood loss in 2h after cesarean section(124.7±20.1ml),and blood loss in 24h after cesarean section(867.5±78.9 ml),and the time of hospital stay(5.0±1.5d)of the women in group A were significant lower than those of the women in group B(P<0.05),but there was no significant difference in the success rate of hemostasis(93.3%vs.86.7%)of the women between group A and group B(P>0.05),the incidence of postoperative complications(10.0%)of the women in group A was significant lower than that(36.8%)of the women in group B(P>0.05).After cesarean section,the values of heart rate,diastolic blood pressure,systolic blood pressure,and other blood flow indexes of the women in both groups were significant higher than those before cesarean section,but which of the women in group A were significant lower than those of the women in group B.The prothrombin time and activated partial prothrombin time of the women in both groups were significant lower than those before cesarean section.The fibrinogen level of the women in both groups was significant higher than that before cesarean section,but the variation range of which of the women in group A was significant higher than that of the women in group B(all P<0.05).Conclusion:The efficacy of Bakri balloon packing for treating postpartum hemorrhage of the women after cesarean section is better than that of B-lynch suture.And the main reason is that Bakri balloon packing is simple and time-saving,so it is more conducive to reducing operation time,improving hemostasis efficiency,and improving maternal blood flow indicators and coagulation function.