超声引导放置Foley导尿管在治疗剖宫产切口妊娠出血中的应用

目的 探讨超声引导下放置Foley水囊在剖宫产切口妊娠清宫术中及术后出血治疗中的应用价值.方法 对76例剖宫产切口妊娠清宫术术中或术后出血患者,于超声引导下放置Foley导尿管,充盈球囊,使之完全压迫出血部位.超声实时观察出血部位,如发现出血量渐增多,则继续压迫止血；如无继续出血,可安全取出球囊.记录术中出血量、注液量及水囊留置时间.结果 76例患者中,35例为孕囊型,41例为混合性包块型；孕囊型术中出血量为(30.16±5.20)ml,注液量(20.11±5.62)ml,水囊留置时间(13.37±4.19)h;混合性包块型术中出血量为(85.88±6.81)ml,注液量(30.12±9.06)ml,水囊留置时间(31.32±8.28)h.对所有患者均成功放置Foley水囊压迫止血,效果良好.结论 超声实时监视下放置Foley导尿管对治疗剖宫产切口妊娠具有较高应用价值.

Application of placement of Foley catheter under the guidance of ultrasound for treatment of bleeding caused by cesarean section pregnancy

Objective To explore ultrasound-guided placement of Foley catheter in the treatment of bleeding during or after cesarean section incision in complete curettage of uterine cavity. Methods Seventy-six patients of cesarean section pregnancy underwent complete curettage of uterine cavity. Hemorrhage occurred in all patients, and ultrasound guided placement of Foley catheter was performed. The balloon was filled to press bleeding point, and the bleeding site was observed with real-time ultrasound. When bleeding deteriorated, the balloon was still used, while bleeding stopped, the balloon could be removed safely. The bleeding amount, amount of injected solution, and time of balloon duration were recorded. Results In 76 cases of cesarean section pregnancy, 35 were embryo sac-like type and 41 were mixed masses. For 35 patients with embryo sac-like type, the bleeding amount during operation was (30.16±5.20)ml, amount of injected solution was (20.11±5.62)ml, and time of balloon duration was (13.37±4.19)h. For 41 patients with mixed masses, the bleeding amount during operation was (85.88±6.81)ml, amount of injected solution was (30.12±9.06)ml, and time of balloon duration was (31.32±8.28)h. Foley catheter was successfully implanted to stop bleeding in all patients, and the prognosis was good. Conclusion Real-time ultrasound-guided placement of Foley catheter has important application value in treatment of bleeding caused by cesarean section pregnancy.