宫腔水囊联合阴道填塞治疗子宫下段收缩乏力性产后出血的有效性和安全性

Efficacy and safety of Foley's catheter compression in uterine cavity combined with vaginal tamponade in the treatment of postpartum hemorrhage due to the lower uterine segment atony

目的探讨宫腔水囊联合阴道填塞在治疗子宫下段收缩乏力性产后出血中的有效性和安全性。方法选取2018年1月至2019年12月赣州市人民医院收治的43例因子宫下段收缩乏力性产后出血患者作为研究对象,均采用宫腔水囊联合阴道填塞方法治疗。分析止血效果及安全性,比较不同分娩方式产后止血效果。结果43例患者止血成功率为95.3%,失败率4.7%。不同分娩患者填塞前平均出血量、止血成功率比较差异无统计学意义;阴道分娩患者填塞至术后24 h出血量少于剖宫产患者,血红蛋白下降值低于剖宫产组,差异有统计学意义(P<0.05)。41例成功止血患者中均无术后发热、宫腔感染、盆腔异常、晚期产后出血等并发症发生,未增加抗生素的使用率及产褥感染率。结论早期使用宫腔水囊联合阴道填塞可有效减少阴道分娩及剖宫产产后出血的出血量,用于治疗子宫下段收缩乏力性产后出血的疗效确切,是一种快速、安全、有效、经济的止血方法。

Objective To investigate the efficacy and safety of Foley's catheter compression in uterine cavity combined with vaginal tamponade in the treatment of postpartum hemorrhage due to the lower uterine segment atony.Methods 43 patients with postpartum hemorrhage due to the lower uterine segment atony from January 2018 to December 2019 in Ganzhou City People's Hospital were were selected as the study subjects,and they were treated with Foley's catheter compression in uterine cavity combined with vaginal tamponade.The hemostasis effect and safety were analyzed,and the hemostasis effect of different delivery methods was compared.Results In 43 patients,the successful rate of hemostasis was 95.3%and the failure rate was 4.7%.There was no significant difference in the average blood loss before tamponade and the success rate of hemostasis among different delivery patients;the blood loss from tamponade to 24 h after operation in patients with vaginal delivery was less than that in patients with cesarean section,and the decrease of hemoglobin was lower than that in patients with cesarean section,and the differences were statistically significant(P<0.05).In 41 patients with successful hemostasis,there were no complications such as postoperative fever,uterine infection,pelvic abnormalities,and late postpartum hemorrhage,and there was no increase in the use of antibiotics or the rate of puerperal infection.Conclusion Early use of Foley's catheter compression in uterine cavity combined with vaginal tamponade can effectively reduce the amount of bleeding after vaginal delivery and cesarean section,and is a rapid,safe,effective and economical method of hemostasis for treating postpartum hemorrhage caused by lower uterine segment atony.