宮腔Bakri球囊填塞在宮縮乏力性產(chǎn)后出血中的應(yīng)用

　　【摘要】 目的：探討宮腔Bakri球囊填塞在宮縮乏力性產(chǎn)后出血中的應(yīng)用。方法：選取2014年
　　1月-2017年1月本院收治宮縮乏力性產(chǎn)后出血初產(chǎn)婦300例作為研究對(duì)象，均給予按摩子宮、藥物止血失敗后行宮腔Bakri球囊填塞止血，回顧性分析其一般資料及臨床資料。結(jié)果：本組患者均順利完成宮腔Bakri球囊填塞，止血有效294例，占98.00%；球囊脫落5例，占1.67%；子宮切除3例，占1.00%；產(chǎn)褥病13例，占4.33%。保留子宮的297例42 d復(fù)查體檢，均子宮復(fù)舊良好。結(jié)論：宮腔Bakri球囊填塞應(yīng)用在剖宮產(chǎn)術(shù)后宮縮乏力性產(chǎn)后出血中有較好的止血效果，可降低因失血而致的臨床后果，且簡便易行，值得臨床推廣應(yīng)用。
　　【關(guān)鍵詞】 Bakri球囊； 宮縮乏力； 產(chǎn)后出血
　　Application of Bakri Postpartum Balloon in Postpartum Hemorrhage Caused by Uterine Inertia/DENG Yufang.//Medical Innovation of China，2018，15（07）：130-132
　　【Abstract】 Objective：To discuss the application of Bakri postpartum balloon in postpartum hemorrhage caused by uterine inertia.Method：A total of 300 uniparas with postpartum hemorrhage caused by uterine inertia in our hospital were selected from January 2014 to January 2017.All uniparas which received uterine massage and drug hemostasis were treated with Bakri postpartum ballon hemostatic saccule after failing in hemostasis，and their general information and clinical datum were retrospectively analyzed.Result：All uniparas were successfully placed Bakri postpartum balloon，294 cases（98.00%）hemostatic effective，5 cases（1.67%） falling off Bakri postpartum balloon，3 cases（1.00%） hysterectomy，13 cases （4.33%）postpartum infection were included in this study.297 cases retaining the uterus recovered well in 42 days review of physical examination.Conclusion：The application of Bakri postpartum balloon in postpartum hemorrhage caused by uterine inertia has good hemostatic effect，it can reduce the loss of blood and clinical consequences.The operation of Bakri postpartum balloon is simple and easy，it is worthy of clinic application.
　　【Key words】 Bakri postpartum balloon； Uterine inertia； Postpartum hemorrhage
　　First-author’s address：The First Maternal and Child Health Care Cente of Huizhou City，Huizhou 516100，China
　　doi：10.3969/j.issn.1674-4985.2018.07.037
　　宮縮乏力是引起產(chǎn)后出血的常見原因，據(jù)不完全統(tǒng)計(jì)產(chǎn)后出血發(fā)生率約占總分娩人數(shù)的4.17%，本院宮縮乏力性產(chǎn)后出血發(fā)生率約占總分娩人數(shù)的2.87%，筆者認(rèn)為由于統(tǒng)計(jì)限制等原因，該兩組數(shù)值遠(yuǎn)低于實(shí)際發(fā)病率[1-2]。迄今宮縮乏力性產(chǎn)后出血仍是威脅產(chǎn)婦生命安全，消極影響孕產(chǎn)婦生活質(zhì)量的重要因素[3-4]。筆者認(rèn)為，若能有效控制宮縮乏力性產(chǎn)后出血，對(duì)于改善孕產(chǎn)婦生命質(zhì)量及生活質(zhì)量或具有積極意義。本院近期采用宮腔Bakri球囊填塞治療宮縮乏力性產(chǎn)后出血獲得良好療效，現(xiàn)報(bào)道如下。
　　1 資料與方法
　　1.1 一般資料 選取2014年1月-2017年1月本院收治宮縮乏力性產(chǎn)后出血初產(chǎn)婦300例作為研究對(duì)象根據(jù)《產(chǎn)后出血預(yù)防與處理指南（2014年版）》中宮縮乏力性產(chǎn)后出血的相關(guān)診斷標(biāo)準(zhǔn)[5]，經(jīng)診斷所有研究對(duì)象均確診為宮縮乏力性產(chǎn)后出血。年齡21.12～34.44歲，平均（27.65±3.61）歲；孕周38+2～41+1周，平均（39.64±0.47）周。剖宮產(chǎn)指征：瘢痕子宮100例，胎盤因素79例，產(chǎn)程異常37例，骨盆狹窄35例，羊水過多7例，巨大胎兒6例，胎兒窘迫5，社會(huì)因素剖宮產(chǎn)31例。單胎妊娠276例，雙胎妊娠24例。流產(chǎn)或引產(chǎn)史61例。納入標(biāo)準(zhǔn)：（1）宮縮乏力性產(chǎn)后出血；（2）無內(nèi)科合并癥。排除標(biāo)準(zhǔn)：（1）剖宮產(chǎn)相關(guān)禁忌證者；（2）低、高齡孕產(chǎn)婦；（3）轉(zhuǎn)院或臨床資料不完整病例；（4）精神疾病及心理障礙病史者。本研究經(jīng)本院倫理委員會(huì)批準(zhǔn)，且研究對(duì)象知情同意。

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