宫腔球囊压迫止血治疗前置胎盘剖宫产产后出血的效果

Effect of intrauterine balloon compression hemostasis on postpartum hemorrhage after cesarean section for placenta previa

目的分析宫腔球囊压迫止血治疗前置胎盘剖宫产产后出血的效果。方法抽取2019年6月至2021年5月周口市妇幼保健院收治的前置胎盘剖宫产产后出血的产妇92例。按照止血方式将其分为对照组和研究组,每组46例,对照组给予B-Lynch缝合止血,研究组给予宫腔球囊压迫止血。比较两组产妇产后出血量、围术期指标(手术时间、住院时间及总输血量)、应激反应指标[去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)]水平及并发症发生率。结果研究组产后2、24 h出血量少于对照组(t=12.50、38.60,P均<0.05)。研究组手术时间、住院时间均短于对照组(t=0.16、16.74,P均<0.05),研究组总输血量少于对照组(t=19.71,P<0.05)。术后24 h,研究组NE、E、Cor水平低于对照组(t=13.50、9.51、9.03,P均<0.05)。研究组总并发症发生率(8.70%,4/46)与对照组(19.56%,9/46)比较,差异未见统计学意义(P>0.05)。结论宫腔球囊压迫止血治疗前置胎盘剖宫产产后出血,可减少术后出血量和输血量,改善机体应激反应,且安全性良好。

Objective To analyze the effect of intrauterine balloon compression hemostasis on postpartum hemorrhage after cesarean section for placenta previa.Methods A total of 92 women with postpartum hemorrhage after cesarean section for placenta previa treated in Zhoukou Maternal and Child Health Hospital from June 2019 to May 2021 were selected.According to the approaches of hemostasis,they were divided into control group and study group,with 46 cases in each group.The control group was given B-Lynch suture hemostasis,while the study group was given intrauterine balloon compression hemostasis.The amount of postpartum hemorrhage,perioperative indexes including operation time,hospital stay and total blood transfusion,the levels of stress response indexes including norepinephrine(NE),epinephrine(E)and cortisol(Cor),and the incidence of complications were compared between the two groups.Results The amount of blood loss in the study group was less than that in the control group 2 hours and 24 hours after delivery(t=12.50,38.60;all P<0.05).The operation duration and hospital stay of the study group were shorter than those of the control group(t=0.16,16.74;all P<0.05).The total blood transfusion volume of the study group was less than that of the control group(t=19.71,P<0.05).Twenty-four hours after operation,the levels of NE,E and Cor of the study group were lower than those of the control group(t=13.50,9.51,9.03;all P<0.05).There was no significant difference in the total complication rate between the study group(8.70%,4/46)and the control group(19.56%,9/46),P>0.05.Conclusions Intrauterine balloon compression hemostasis in the treatment of postpartum hemorrhage after cesarean section for placenta previa can reduce postoperative blood loss and blood transfusion,improve the body’s stress response,and it is safe.