Nagai Sayori, Kobayashi Hiroaki, Nagata Tomomi, Hiwatashi Sayuri, Kawamura Toshihiko, Yokomine Daisaku, Orita Yuji, Oki Toshimichi, Yoshinaga Mitsuhiro, Douchi Tsutomu
Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University.
Kurume Med J. 2016;62(1-2):17-21. doi: 10.2739/kurumemedj.MS65004. Epub 2016 Mar 1.
Intrauterine globe-shaped metreurynter tamponade has been used for some time to treat massive postpartum hemorrhage (PPH). More recently, the Bakri balloon has come into use to treat PPH. It is made of silicon, possesses a drainage lumen, and has a sausage-like spindle shape. The aim of the present study was to investigate the clinical usefulness of Bakri balloon tamponade for massive PPH. Subjects in the present study comprised 5 patients with uterine atony, 3 with placenta previa, and 2 with low-lying placenta. All patients exhibited massive PPH and resistance to conventional hemostatic managements. Bakri balloon tamponade was appliedto these 10 patients. The mean amounts of uterine bleeding (average ± SD) before and after Bakri insertion were2,732 ± 1,397 mL and 380 ± 376 mL, respectively. The median (third-first quartile ranges) volume of salineinflating the balloon was 200 mL (300-150 mL). The median (third-first quartile ranges) indwelling duration of Bakri balloon was 24 hours (24-11 hrs). The overall success rate of Bakri balloon tamponade was 90% (9/10).There were no cases of slipping out or complications regarding balloon placement. Our findings suggest that Bakri balloon tamponade may be applied to the treatment of massive PPH in uterine atony and placenta previa.The Bakri balloon appears to have the following merits: (1) easy insertion into the uterine cavity and low rate of slipping out, (2) proper conformability to the hemorrhagic area due to its spindle shape, (3) ability to monitor blood loss through the drainage lumen even after insertion.
宫内球囊填塞法已被用于治疗产后大出血（PPH）一段时间了。最近，巴克里球囊开始用于治疗PPH。它由硅制成，有一个引流管腔，呈香肠状纺锤形。本研究的目的是探讨巴克里球囊填塞法治疗大量PPH的临床实用性。本研究的对象包括5例子宫收缩乏力患者、3例前置胎盘患者和2例低置胎盘患者。所有患者均出现大量PPH且对传统止血处理无效。对这10例患者应用了巴克里球囊填塞法。插入巴克里球囊前后子宫平均出血量（平均值±标准差）分别为2732±1397 mL和380±376 mL。充盈球囊的生理盐水体积中位数（四分位数间距）为200 mL（300 - 150 mL）。巴克里球囊的留置时间中位数（四分位数间距）为24小时（24 - 11小时）。巴克里球囊填塞法的总体成功率为90%（9/10）。没有球囊脱出或放置相关并发症的病例。我们的研究结果表明，巴克里球囊填塞法可用于治疗子宫收缩乏力和前置胎盘引起的大量PPH。巴克里球囊似乎具有以下优点：（1）易于插入宫腔且脱出率低；（2）由于其纺锤形，对出血区域具有良好的贴合性；（3）即使在插入后也能通过引流管腔监测失血量。
