COOK球囊压迫止血治疗难治性产后出血失败的原因分析

目的 分析难治性产后出血(postpartum hemorrhage,PPH)患者行宫腔COOK球囊放置治疗失败的可能影响因素.方法 回顾性分析2016年1月至2020年12月于北京市通州区妇幼保健院治疗的难治性PPH产妇107例,皆实施宫腔置COOK球囊压迫术治疗,以是否止血成功分为两组:成功组(89例)和失败组(1...

Analysis of the reasons for the failure of COOK balloon compression hemostasis in the treatment of refractory postpartum hemorrhage

Objective To investigate the factors influencing the failure of COOK balloon compression hemostasis of refractory postpartum hemorrhage PPH.Methods A retrospective analysis of 107 puerperae with refractory PPH treated in Tongzhou Maternal and Child Health Care Hospital of Beijing from January 2016 to December 2020,all underwent COOK balloon compression in the uterus.They were divided into two groups according to whether the hemostasis was successful or not: the success group(89 cases) and the failure group(18 cases).The general data and treatment-related parameters of the two groups were compared, and the influencing factors of treatment failure were analyzed by Logistic regression.Results Comparison of basic data showed that the proportions of combination with uterine fibroids, placenta previa, placenta increta, and blood transfusion in failure group were significantly higher than those in the success group.Comparing treatment-related indicators, the amount of preoperative bleeding, bleeding volume 30 minutes after surgery, bleeding volume an hour after surgery and total bleeding in failure group were significantly higher than those in the success group, and the balloon infusion volume and indwelling time were lower than those in the success group(P<0.05).Logistic analysis showed that: pregnancy with uterine fibroids, placenta previa, bleeding volume 30 minutes after surgery, bleeding volume an hour after surgery, total bleeding volume and indwelling time are the influencing factors for the failure of balloon compression to stop bleeding(P<0.05).Conclusion For patients with refractory PPH,COOK balloon compression hemostasis therapy in the uterus has a good hemostatic effect.Pregnancy with uterine fibroids, placenta previa, bleeding volume 30 minutes after surgery, bleeding volume an hour after surgery, total bleeding and indwelling time may all be the reasons for failure of compression hemostasis with COOK balloon in the uterine cavity.