[1]卢珊 张龑** 张赐敏 陈练 侯征 于洋.序贯宫颈钳夹联合宫腔水囊放置术治疗前置胎盘产后出血[J].中国微创外科杂志,2020,01(3):268-271.
　Lu Shan,Zhang Yan,Zhang Cimin,et al.Sequential Cervical Clamping Combined With Uterine Tamponade Balloon in the Management of Postpartum Hemorrhage of Placenta Previa[J].Chinese Journal of Minimally Invasive Surgery,2020,01(3):268-271.
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序贯宫颈钳夹联合宫腔水囊放置术治疗前置胎盘产后出血()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年3期
页码:
268-271
栏目:
经验交流
出版日期:
2020-03-25

文章信息/Info

Title:
Sequential Cervical Clamping Combined With Uterine Tamponade Balloon in the Management of Postpartum Hemorrhage of Placenta Previa
作者:
卢珊 张龑** 张赐敏 陈练 侯征 于洋
（北京大学第三医院妇产科，北京100191）
Author(s):
Lu Shan;  Zhang Yan;  Zhang Cimin;  et al.
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
关键词:
产后出血; 前置胎盘; 宫腔水囊
Keywords:
Postpartum hemorrhage; Placenta previa; Uterine tamponade
文献标志码:
B
摘要:
目的探讨序贯宫颈钳夹联合自制宫腔手套水囊放置术治疗边缘性前置胎盘和低置胎盘阴道分娩产后出血的可行性。方法采用前瞻性单组临床研究的方法，将我科2017年1月~2019年8月边缘性前置胎盘和低置胎盘剥离后产后出血经保守治疗失败的18例纳入研究，采用序贯宫颈钳夹联合自制宫腔手套水囊放置术（先行双侧宫颈钳夹，再用无菌橡胶手套制成水囊放置宫腔）治疗。结果4例单纯宫颈钳夹即控制产后出血，13例序贯治疗成功，1例宫颈钳夹序贯宫腔水囊填塞压迫无法控制出血转开腹止血。13例序贯治疗成功平均注液量450 ml(300～540 ml），控制出血时间平均5.2 min(4～10 min),平均产后出血量1321 ml（800～2700 ml)，平均水囊留置时间12 h（8～24 h)，输血率72.2%（13/18），平均产后住院时间4 d(2～10 d）。18例产后42 d复查均子宫复旧正常。结论序贯宫颈钳夹联合宫腔水囊放置术治疗前置胎盘产后出血的方法简单、有效、可行。
Abstract:
ObjectiveTo study the feasibility of sequential cervical clamping combined with uterine tamponade by using selfmade glove catheter balloon in treating postpartum hemorrhage (PPH) due to marginal placenta previa and lowlying placenta.MethodsThis prospective, single arm study was conducted. Eighteen patients with PPH due to marginal placenta previa and lowlying placenta who failed on traditional treatment were included in the study. After clamping bilateral cervix, balloon tamponade achieved by a sterile rubber glove filled with saline was placed into the uterine cavity and kept in situ for 8-24 hours. ResultsOf the 18 patients, 17 were controlled successfully (success rate 94.4%). Among them, 4 were treated by single intrauterine forceps, and 13 were treated by sequential treatments. Only 1 case failed. The mean volume of fluid filled in the catheter balloon was 450 ml (range, 300-540 ml). The mean time taken to control bleeding was 5.2 min (range, 4-10 min). The average amount of hemorrhage was 1321 ml (range, 800-2700 ml). The mean duration for catheter balloon placement in situ was 12 h (range, 8-24 h). The blood transfusion rate was 72.2%(13/18), and the mean hospitalization time was 4 d (range, 2-10 d).All 18 cases recovered well 42 days after delivery.ConclusionSequential cervical clamping combined with uterine tamponade balloon for PPH due to placenta pravia is simple,effective,and feasible.

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备注/Memo

备注/Memo:
基金项目：北京市首都市民健康培育项目（Z171100000417047）**通讯作者，Email：zhangyann01@126.com
更新日期/Last Update: 2020-06-19