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摘要:
目的 探讨Bakri子宫填塞球囊导管(Bakri球囊)在治疗产后出血中的作用。 方法 回顾性分析2012年1月至7月间北京协和医院收治的因产后出血使用Bakri球囊治疗的患者的病例特点, 并分析其治疗效果。 结果 剖宫产术中应用Bakri球囊治疗产后出血8例, 其中7例合并有前置胎盘。2例患者发生弥散性血管内凝血。共3例患者放置球囊后采取后续侵入性治疗, 其中2例患者同时合并有中央性前置胎盘、前次剖宫产史及胎盘植入。所有患者术后无明显疼痛, 无产后发热及死亡病例。 结论 Bakri球囊能够治疗产后出血, 并不增加术后病率。球囊放置后应加强监护, 对于治疗无效者应尽早采取更积极的治疗。合并有剖宫产史、胎盘植入或胎盘黏连的中央性前置胎盘可能是影响放置成功率的因素。 Abstract:Objective To investigate the role of Bakri balloon insertion following unsuccessful medical management of postpartum haemorrhage (PPH). Methods The clinical features of patients with PPH managed with Bakri balloon in our department between January and July 2012 were retrospectively reviewed. The therapeutic role of Bakri balloon was analyzed. Results Eight cases were managed with Bakri balloon during the study period. Caesarean section (CS) was performed in all these cases, among whom seven were due to placenta previa. Two cases had disseminated intravascular coagulation (DIC). Three cases needed a second procedure to stop the bleeding, among whom two had placenta previa, previous CS, and placenta accreta. No patient experienced postpartum abdominal pain or fever. Conclusions Bakri balloon tamponade is effective and safe in the management of PPH unresponsive to standard management. Patients should be carefully monitored after the placement of Bakri balloon. Central placenta previa with a history of CS, placenta accreta or placenta adherence may impact the success of Bakri balloon placement. -
Key words:
- postpartum haemorrhage /
- Bakri balloon
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表 1 放置Bakri球囊患者的临床资料
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[1] 丰有吉, 沈铿.妇产科学[M]. 2版.北京: 人民卫生出版社, 2010. [2] Georgiou C. Balloon tamponade in the management of postpartum haemorrhage:a review[J]. BJOG, 2009, 116:748-757. doi: 10.1111/j.1471-0528.2009.02113.x [3] Bakri YN. Uterine tamponade-drain for hemorrhage secondary to placenta previa-accreta[J]. Int J Gynaecol Obstet, 1992, 37:302-303. http://www.ncbi.nlm.nih.gov/pubmed/1350550 [4] Bakri YN. Balloon device for control of obstetrical bleeding[J]. Eur J Obstet Gynecol Reprod Biol, 1999, 86:S84. http://www.researchgate.net/publication/292019849_Balloon_device_for_control_of_obstetrical_bleeding [5] Vitthala S, Tsoumpou I, Anjum ZK, et al. Use of Bakri balloon in post-partum haemorrhage:A series of 15 cases[J]. Aust N Z J Obstet Gynaecol, 2009, 49:191-194. doi: 10.1111/j.1479-828X.2009.00968.x/full [6] Bakri YN, Amir A, Abdul Jabbar F. Tamponade balloon for obstetrical bleeding[J]. Int J Gynecol Obstet, 2001, 74:139-142. http://www.ncbi.nlm.nih.gov/pubmed/11502292 [7] Debelea V, Schultze PM, McDuffie RS. Intrauterine balloon tamponade in the management of postpartum haemorrhage[J]. Am J Perinatol, 2007, 24:359-364. http://www.ingentaconnect.com/content/thiem/07351631/2007/00000024/00000006/art00005 -
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