Bakri子宫填塞球囊导管在难治性产后出血中的应用及失败原因分析

发布时间：2018-11-17 09:49

【摘要】：目的探讨Bakri子宫填塞球囊导管在治疗难治性产后出血中的应用,并对其止血失败的原因进行分析。方法回顾性分析2013年1月-2015年9月该院收治的因难治性产后出血使用Bakri球囊治疗的患者,分析其治疗效果,并对其止血失败的原因进行分析。结果该研究应用Bakri子宫填塞球囊导管患者共91例,产后出血原因主要为前置胎盘、子宫收缩乏力和胎盘植入。止血成功82例,成功率为90.1%;止血失败9例,失败率9.9%。9例失败患者中胎盘植入残留胎盘出血、休克及弥散性血管内凝血(DIC)未纠正、球囊脱出或注液不足是失败的因素。结论 Bakri子宫填塞球囊导管应用相对简便,容易掌握,可以实时观察出血量,有效治疗产后出血。前置胎盘伴胎盘植入,产后出血伴休克、DIC;球囊放置不当或注液不足是引起放置球囊失败的主要原因,预防性应用Bakri球囊导管有待进一步研究。
[Abstract]:Objective to investigate the application of Bakri uterine tamponade balloon catheter in the treatment of refractory postpartum hemorrhage and to analyze the causes of its failure in hemostasis. Methods the patients treated with Bakri balloon for refractory postpartum hemorrhage from January 2013 to September 2015 were analyzed retrospectively. The therapeutic effect was analyzed and the reasons for the failure of hemostasis were analyzed. Results in this study, 91 patients were treated with Bakri uterine tamponade balloon catheter. The main causes of postpartum hemorrhage were placenta previa, uterine atony and placenta accreta. 82 cases were successful in hemostasis, the success rate was 90.1%. There were 9 cases of hemostatic failure, the failure rate of 9. 9% and 9. 9% of the patients with placenta accreta residual placenta hemorrhage, shock and disseminated intravascular coagulation (DIC) were not corrected, balloon prolapse or insufficient injection were the factors of failure. Conclusion Bakri uterine tamponade balloon catheter is relatively simple and easy to grasp. It can be used to observe blood loss in real time and to treat postpartum hemorrhage effectively. Placenta previa with placenta accreta, postpartum hemorrhage with shock, improper placement of DIC; balloon or insufficient injection of liquid were the main reasons for the failure of balloon placement. Prophylactic use of Bakri balloon catheter needs further study.
【作者单位】：南方医科大学附属小榄医院;
【分类号】：R714.461

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