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前置胎盘患者剖宫产术中 Bakri 球囊填塞与子宫纱布填塞的预防性应用

Prophylactic application of Bakri balloon tamponade versus uterine gauze packing during cesarean section in patients with placenta previa.

作者信息

Lin Baohua, Zhou Bei, Chen Juanhua, Yang Jinying

机构信息

Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

出版信息

J Int Med Res. 2020 Mar;48(3):300060520910049. doi: 10.1177/0300060520910049.

DOI:10.1177/0300060520910049
PMID:32216508
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7133395/
Abstract

OBJECTIVE

This study was performed to compare the effectiveness of routine Bakri balloon tamponade (BBT) and uterine gauze packing (UGP) during cesarean section in patients with placenta previa.

METHODS

This study involved women with placenta previa who underwent cesarean section with either prophylactic BBT (n = 98) or UGP (n = 64) from January 2016 to December 2018. The clinical variables and pregnancy outcomes were compared between the two groups.

RESULTS

The estimated intraoperative blood loss was significantly lower in the BBT than UGP group (667 ± 358 vs. 791 ± 360 ml, respectively). Additionally, the proportion of patients who required transfusion was significantly lower in the BBT than UGP group (9/98 vs. 17/64, respectively). The operative duration (97.8 ± 17.7 vs. 108.2 ± 16.9 minutes) and the length of stay (3.79 ± 0.89 vs. 4.12 ± 0.85 days) were significantly shorter in the BBT than UGP group.

CONCLUSIONS

In patients with placenta previa who undergo cesarean section, preventive application of BBT is superior to UGP for decreasing the intraoperative blood loss and transfusion rate. BBT is a more reliable technique to prevent and control postpartum hemorrhage.

摘要

目的

本研究旨在比较前置胎盘患者剖宫产术中常规 Bakri 球囊填塞(BBT)和子宫纱布填塞(UGP)的有效性。

方法

本研究纳入了 2016 年 1 月至 2018 年 12 月期间因前置胎盘行剖宫产术的患者,其中接受预防性 BBT 的患者有 98 例,接受 UGP 的患者有 64 例。比较两组患者的临床变量和妊娠结局。

结果

BBT 组估计术中出血量显著低于 UGP 组(分别为 667±358 毫升和 791±360 毫升)。此外,BBT 组需要输血的患者比例显著低于 UGP 组(分别为 9/98 和 17/64)。BBT 组的手术时间(97.8±17.7 分钟对 108.2±16.9 分钟)和住院时间(3.79±0.89 天对 4.12±0.85 天)均显著短于 UGP 组。

结论

对于行剖宫产术的前置胎盘患者,预防性应用 BBT 在减少术中出血量和输血率方面优于 UGP。BBT 是预防和控制产后出血更可靠的技术。

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本文引用的文献

1
Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section.巴克里球囊填塞术常规快速置入对减少剖宫产术中及术后前置胎盘出血的影响。
Arch Gynecol Obstet. 2017 Sep;296(3):469-474. doi: 10.1007/s00404-017-4446-1. Epub 2017 Jun 24.
2
Comparison between two management protocols for postpartum hemorrhage during cesarean section in placenta previa: Balloon protocol versus non-balloon protocol.前置胎盘剖宫产术中两种产后出血管理方案的比较:球囊方案与非球囊方案。
J Obstet Gynaecol Res. 2017 Mar;43(3):447-455. doi: 10.1111/jog.13227. Epub 2016 Dec 17.
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Does uterine gauze packing increase the risk of puerperal morbidity in the management of postpartum hemorrhage during caesarean section: a retrospective cohort study.剖宫产术中子宫纱布填塞在产后出血管理中会增加产褥期发病风险吗:一项回顾性队列研究
Int J Clin Exp Med. 2015 Aug 15;8(8):13740-7. eCollection 2015.
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Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.宫内 Bakri 球囊填塞术在前置胎盘患者剖宫产中的疗效
PLoS One. 2015 Aug 11;10(8):e0134282. doi: 10.1371/journal.pone.0134282. eCollection 2015.
5
A different approach to placenta previa accreta: intrauterine gauze compress combined B-Lynch uterine compression suture.前置胎盘植入的一种不同方法:宫腔纱布填塞联合B-Lynch子宫压迫缝合术。
Clin Exp Obstet Gynecol. 2015;42(1):53-6.
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Placenta previa: an outcome-based cohort study in a contemporary obstetric population.前置胎盘:当代产科人群中一项基于结局的队列研究。
Arch Gynecol Obstet. 2015 Aug;292(2):299-305. doi: 10.1007/s00404-015-3628-y. Epub 2015 Feb 1.
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Bakri balloon during cesarean delivery for placenta previa.Bakri 球囊在前置胎盘剖宫产术中的应用。
Int J Gynaecol Obstet. 2014 Feb;124(2):118-22. doi: 10.1016/j.ijgo.2013.08.010. Epub 2013 Oct 31.
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Prevalence of placenta praevia by world region: a systematic review and meta-analysis.按世界区域划分的前置胎盘患病率:系统评价和荟萃分析。
Trop Med Int Health. 2013 Jun;18(6):712-24. doi: 10.1111/tmi.12100. Epub 2013 Apr 1.
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Predicting factors for emergency peripartum hysterectomy in women with placenta previa.预测前置胎盘产妇行急诊剖宫产术的相关因素。
Arch Gynecol Obstet. 2012 Apr;285(4):901-6. doi: 10.1007/s00404-011-2074-8. Epub 2011 Sep 7.
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Uterine packing during cesarean section in the management of intractable hemorrhage in central placenta previa.剖宫产术中子宫填塞在中央性前置胎盘难治性出血中的应用。
Arch Gynecol Obstet. 2012 Feb;285(2):285-9. doi: 10.1007/s00404-011-1935-5. Epub 2011 Jun 7.