Guo Yuna, Hua Renyi, Bian Shoufang, Xie Xianjing, Ma Jue, Cai Yanqin, Sooranna Suren R, Cheng Weiwei
International Peace Maternity and Child Health Hospital of China Welfare Institution (IPMCH), Shanghai, China.
Imperial College Parturition Research Group, Academic Department of Obstetrics & Gynaecology, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, UK.
J Obstet Gynaecol Can. 2018 May;40(5):561-565. doi: 10.1016/j.jogc.2017.08.035. Epub 2017 Oct 19.
This study sought to investigate the effect of Bakri balloon use and vaginal tamponade combined with abdominal compression for the management of postpartum hemorrhage (PPH).
This retrospective study reviewed cases of PPH in the International Peace Maternal and Child Health Hospital of China Welfare Institution in Shanghai, China from January 1, 2010 to December 31, 2015. A single use of the intrauterine Bakri balloon was applied in some cases, and additional vaginal tamponade combined with abdominal compression (double compression) was applied in other cases. The authors evaluated the effect of these two methods in the management of PPH.
The Bakri balloon was used in 305 cases of intrauterine PPH, and the clinical efficacy was 93.26%. One group of study patients underwent double compression, and these patients had a better clinical efficacy rate of 96.3% (157 of 163), whereas the efficacy in cases using the Bakri balloon alone (control group) was 87.3% (124 of 142). The postoperative complication rates of these two groups were 9.4% and 8.7%, respectively. Uterine arterial embolization was performed in patients in whom Bakri balloon use failed. None of the cases resulted in a hysterectomy.
Intrauterine Bakri balloon use combined with vaginal tamponade and abdominal compression is more effective in the treatment of PPH compared with Bakri balloon use alone. This method does not increase postoperative complications. Uterine atony with placenta previa or implantation may be possible reasons for noneffectiveness of Bakri balloon use.
本研究旨在探讨使用 Bakri 球囊及阴道填塞联合腹部按压治疗产后出血（PPH）的效果。
这项回顾性研究对 2010 年 1 月 1 日至 2015 年 12 月 31 日在中国福利会国际和平妇幼保健院发生 PPH 的病例进行了回顾。部分病例单独使用宫内 Bakri 球囊，其他病例则采用额外的阴道填塞联合腹部按压（双重按压）。作者评估了这两种方法在治疗 PPH 中的效果。
305 例宫内 PPH 患者使用了 Bakri 球囊，临床有效率为 93.26%。一组研究患者接受了双重按压，这些患者的临床有效率更高，为 96.3%（163 例中的 157 例），而单独使用 Bakri 球囊的病例（对照组）有效率为 87.3%（142 例中的 124 例）。这两组的术后并发症发生率分别为 9.4%和 8.7%。Bakri 球囊使用失败的患者接受了子宫动脉栓塞术。所有病例均未导致子宫切除术。
与单独使用 Bakri 球囊相比，宫内使用 Bakri 球囊联合阴道填塞及腹部按压治疗 PPH 更有效。该方法不会增加术后并发症。前置胎盘或胎盘植入导致的子宫收缩乏力可能是 Bakri 球囊使用无效的原因。
