宫腔Bakri球囊填塞在宫缩乏力性产后出血中的应用
【摘要】 目的：探讨宫腔Bakri球囊填塞在宫缩乏力性产后出血中的应用。方法：选取2014年
1月-2017年1月本院收治宫缩乏力性产后出血初产妇300例作为研究对象，均给予按摩子宫、药物止血失败后行宫腔Bakri球囊填塞止血，回顾性分析其一般资料及临床资料。结果：本组患者均顺利完成宫腔Bakri球囊填塞，止血有效294例，占98.00%；球囊脱落5例，占1.67%；子宫切除3例，占1.00%；产褥病13例，占4.33%。保留子宫的297例42 d复查体检，均子宫复旧良好。结论：宫腔Bakri球囊填塞应用在剖宫产术后宫缩乏力性产后出血中有较好的止血效果，可降低因失血而致的临床后果，且简便易行，值得临床推广应用。
【关键词】 Bakri球囊； 宫缩乏力； 产后出血
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
宮缩乏力是引起产后出血的常见原因，据不完全统计产后出血发生率约占总分娩人数的4.17%，本院宫缩乏力性产后出血发生率约占总分娩人数的2.87%，笔者认为由于统计限制等原因，该两组数值远低于实际发病率[1-2]。迄今宫缩乏力性产后出血仍是威胁产妇生命安全，消极影响孕产妇生活质量的重要因素[3-4]。笔者认为，若能有效控制宫缩乏力性产后出血，对于改善孕产妇生命质量及生活质量或具有积极意义。本院近期采用宫腔Bakri球囊填塞治疗宫缩乏力性产后出血获得良好疗效，现报道如下。
1 资料与方法
1.1 一般资料 选取2014年1月-2017年1月本院收治宫缩乏力性产后出血初产妇300例作为研究对象根据《产后出血预防与处理指南（2014年版）》中宫缩乏力性产后出血的相关诊断标准[5]，经诊断所有研究对象均确诊为宫缩乏力性产后出血。年龄21.12～34.44岁，平均（27.65±3.61）岁；孕周38+2～41+1周，平均（39.64±0.47）周。剖宫产指征：瘢痕子宫100例，胎盘因素79例，产程异常37例，骨盆狭窄35例，羊水过多7例，巨大胎儿6例，胎儿窘迫5，社会因素剖宫产31例。单胎妊娠276例，双胎妊娠24例。流产或引产史61例。纳入标准：（1）宫缩乏力性产后出血；（2）无内科合并症。排除标准：（1）剖宫产相关禁忌证者；（2）低、高龄孕产妇；（3）转院或临床资料不完整病例；（4）精神疾病及心理障碍病史者。本研究经本院伦理委员会批准，且研究对象知情同意。