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目的对比两种不同处理方式防治产后出血的临床效果与安全性,为产后出血防治策略的选择提供参考依据。方法选取204例产妇为研究对象,按照其止血时机分为高危产后出血组(n=108)及产后出血组(n=96),并按照其处理方式分为Bakir球囊填塞组(n=74)、B-Lynch缝合组(n=130)。记录两组产妇止血效果及子宫复旧情况,比较两组的临床效果与安全性。结果两组产妇住院时间、产后感染率、子宫复旧不良率比较,差异无统计学意义(P>0.05)。Bakir球囊填塞组手术时间低于B-Lynch缝合组,差异有统计学意义(P<0.05);高危产后出血组手术时间、住院时间、出血量、术后24 h血红蛋白变化均低于产后出血组,差异有统计学意义(P<0.05)。204例产妇中,188例(92.16%)止血成功,16例(7.84%)止血失败,其中13例行子宫动脉栓塞、3例行子宫切除术。存在混合因素的产妇,其止血失败率高于无高危因素者、存在子宫因素者、存在胎盘因素者,差异有统计学意义(P<0.05)。结论 Bakir球囊填塞操作耗时更短,适用于应急止血。同时,需重视合并混合因素产妇的早期产后出血防治。
Objective To compare the clinical effects and safety of two different treatments in prevention and treatment of postpartum hemorrhage and provide reference for the selection of prevention and treatment strategies for postpartum hemorrhage. Methods A total of 204 maternal women were enrolled in this study. They were divided into high-risk postpartum hemorrhage group (n = 108) and postpartum hemorrhage group (n = 96) according to their timing of hemostasis. ), B-Lynch suture group (n = 130). The two groups of maternal hemostatic effect and uterine involution were recorded, and the clinical effects and safety of the two groups were compared. Results There was no significant difference in hospitalization time, postpartum infection rate and uterine involution rate between the two groups (P> 0.05). The operative time in Bakir balloon-filled group was lower than that in B-Lynch suture group (P <0.05). The operation time, hospitalization time, blood loss and postoperative 24 h hemoglobin in high-risk postpartum hemorrhage group were lower than that in postpartum hemorrhage Group, the difference was statistically significant (P <0.05). Of the 204 mothers, 188 (92.16%) successfully stopped the bleeding and 16 (7.84%) failed to stop the bleeding. Thirteen patients underwent uterine arterial embolization and three received hysterectomy. There was a mixed factor of maternal, hemostatic failure rate was higher than those without risk factors, the presence of uterine factors, the presence of placental factors, the difference was statistically significant (P <0.05). Conclusion Bakir balloon packing operation takes less time and is suitable for emergency hemostasis. At the same time, attention should be paid to the prevention and treatment of early postpartum hemorrhage in mixed mothers.