Suppr超能文献

宫腔球囊填塞术与子宫纱布填塞术治疗产后出血的安全性和有效性:一项系统评价与Meta分析

Safety and efficacy of intrauterine balloon tamponade vs uterine gauze packing in managing postpartum hemorrhage: A systematic review and meta-analysis.

作者信息

Abul Ahmad, Al-Naseem Abdulrahman, Althuwaini Abdulwahab, Al-Muhanna Abdulredha, Clement Naomi S

机构信息

School of Medicine, University of Leeds, Leeds, United Kingdom (XX Abul, XX Althuwaini, and XX Al-Muhanna).

School of Medical Sciences, University of Manchester, Manchester, United Kingdom (XX Al-Naseem).

出版信息

AJOG Glob Rep. 2022 Nov 5;3(1):100135. doi: 10.1016/j.xagr.2022.100135. eCollection 2023 Feb.

Abstract

BACKGROUND

There is debate on whether uterine gauze packing or intrauterine balloon tamponade is safer and more effective as a surgical management option for treating postpartum hemorrhage.

OBJECTIVE

This study aimed to compare intra- and postoperative outcomes of intrauterine balloon tamponade and uterine gauze packing in patients with postpartum hemorrhage.

STUDY DESIGN

A range of databases such as Cochrane and PubMed were searched using terms including "post-partum haemorrhage," "uterine balloon tamponade," and "uterine gauze packing." All observational studies comparing intrauterine balloon tamponade with uterine gauze packing were included. Five studies were identified enrolling 821 adult patients diagnosed with postpartum hemorrhage. Primary outcomes included blood loss volume, success rates, and maternal mortality. Secondary outcomes comprised requiring additional interventions, postoperative hemoglobin levels, and requiring blood transfusions. Fixed and random models were used for analysis.

RESULTS

Intrauterine balloon tamponade seemed to be a superior option to uterine gauze packing. Intrauterine balloon tamponade was better in reducing intraoperative blood loss, with a statistically significant improvement (<.0001). Cases managed with intrauterine balloon tamponade seemed to have statistically significant shorter operative time (=.023) and hospital length of stay (=.020) in one study.

CONCLUSION

Intrauterine balloon tamponade remains more effective and safer as a first-line surgical management option for postpartum hemorrhage compared with uterine gauze packing.

摘要

背景

对于子宫纱布填塞术或宫腔球囊压迫止血法作为治疗产后出血的手术管理选项,哪一种更安全、更有效,目前存在争议。

目的

本研究旨在比较宫腔球囊压迫止血法和子宫纱布填塞术治疗产后出血患者的术中及术后结果。

研究设计

使用包括“产后出血”、“宫腔球囊压迫止血法”和“子宫纱布填塞术”等术语检索了一系列数据库,如Cochrane和PubMed。纳入了所有比较宫腔球囊压迫止血法与子宫纱布填塞术的观察性研究。共确定了5项研究,纳入了821例诊断为产后出血的成年患者。主要结局包括失血量、成功率和孕产妇死亡率。次要结局包括是否需要额外干预、术后血红蛋白水平以及是否需要输血。采用固定模型和随机模型进行分析。

结果

宫腔球囊压迫止血法似乎是比子宫纱布填塞术更好的选择。宫腔球囊压迫止血法在减少术中失血量方面效果更好,具有统计学意义的改善(<.0001)。在一项研究中,采用宫腔球囊压迫止血法治疗的病例手术时间(=.023)和住院时间(=.020)在统计学上似乎显著更短。

结论

与子宫纱布填塞术相比,宫腔球囊压迫止血法作为产后出血的一线手术管理选项仍然更有效、更安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba7/9791175/d2591e5a7901/gr1.jpg

相似文献

2
Uterine packing with chitosan-covered gauze compared to balloon tamponade for managing postpartum hemorrhage.
Eur J Obstet Gynecol Reprod Biol. 2019 Sep;240:151-155. doi: 10.1016/j.ejogrb.2019.06.003. Epub 2019 Jun 18.
3
Mechanical and surgical interventions for treating primary postpartum haemorrhage.
Cochrane Database Syst Rev. 2020 Jul 1;7(7):CD013663. doi: 10.1002/14651858.CD013663.
5
Intrauterine devices in the management of postpartum hemorrhage.
Am J Obstet Gynecol. 2024 Mar;230(3S):S1076-S1088. doi: 10.1016/j.ajog.2023.08.015. Epub 2023 Aug 30.
8
The association between intrauterine balloon tamponade duration and postpartum hemorrhage outcomes.
Am J Obstet Gynecol. 2017 Mar;216(3):300.e1-300.e5. doi: 10.1016/j.ajog.2016.10.040. Epub 2016 Nov 4.
10
Uterine balloon tamponade for the treatment of postpartum hemorrhage: a systematic review and meta-analysis.
Am J Obstet Gynecol. 2020 Apr;222(4):293.e1-293.e52. doi: 10.1016/j.ajog.2019.11.1287. Epub 2020 Jan 6.

本文引用的文献

1
Mechanical and surgical interventions for treating primary postpartum haemorrhage.
Cochrane Database Syst Rev. 2020 Jul 1;7(7):CD013663. doi: 10.1002/14651858.CD013663.
3
Second generation of intrauterine balloon tamponade: new perspective.
BMJ Innov. 2020 Jan;6(1):1-3. doi: 10.1136/bmjinnov-2019-000404. Epub 2020 Jan 20.
5
Uterine balloon tamponade for the treatment of postpartum hemorrhage: a systematic review and meta-analysis.
Am J Obstet Gynecol. 2020 Apr;222(4):293.e1-293.e52. doi: 10.1016/j.ajog.2019.11.1287. Epub 2020 Jan 6.
6
Uterine packing with chitosan-covered gauze compared to balloon tamponade for managing postpartum hemorrhage.
Eur J Obstet Gynecol Reprod Biol. 2019 Sep;240:151-155. doi: 10.1016/j.ejogrb.2019.06.003. Epub 2019 Jun 18.
7
Intrauterine Balloon Tamponade for Severe Postpartum Hemorrhage.
Obstet Gynecol. 2018 Jan;131(1):143-149. doi: 10.1097/AOG.0000000000002405.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验