Bakri球囊填塞术联合米非司酮治疗凶险性前置胎盘的疗效观察

目的探讨Bakri球囊填塞术联合米非司酮治疗凶险性前置胎盘的临床疗效。方法回顾性分析2016年10月至2018年10月期间在丽水市人民医院妇产科住院治疗的108例凶险性前置胎盘产妇的病历资料。根据治疗方案不同分为对照组和观察组,对照组患者在常规治疗的基础上给予Bakri球囊填塞术治疗,观察组同时给予米非司酮辅助治疗,记录并比较两组产妇手术一般情况、手术前后血常规和血气指标、母婴预后情况。结果观察组产妇的术中出血量、术后24h出血量均显著少于对照组(t值分别为4.881、8.998,均P<0.05),且治疗时间、住院时间均显著短于对照组(t值分别为6.704、3.460,均P<0.05),观察组产妇产后出血发生率显著低于对照组(P<0.05)。两组患者术前血红蛋白(HB)、血小板(PLT)、血氧饱和度(SpO2)和中心静脉压(CVP)比较差异均无统计学意义(均P>0.05),对照组产妇术后HB、PLT、CVP较术前显著下降(t值分别为6.128、4.028、2.967,均P<0.05),且对照组术后HB、PLT、CVP均显著低于观察组术后(t值分别为5.740、3.707、3.150,均P<0.05)。观察组产妇产褥病发生率显著低于对照组(P<0.05),新生儿Apgar评分显著高于对照组(t=2.990,P<0.05),而两组产妇子宫切除率、弥漫性血管内凝血(DIC)发生率比较差异均无统计学意义(均P>0.05)。结论Bakri球囊填塞术联合米非司酮治疗凶险性前置胎盘产妇的止血效果良好,可缩短产妇治疗时间和住院时间,有效维持其生命体征平稳,降低产褥病发生率,改善母婴预后。

Efficacy of Bakri balloon tamponade combined with mifepristone in the treatment of dangerous placenta previa

Objective To explore the efficacy of Bakri balloon tamponade combined with mifepristone in the treatment of dangerous placenta previa.Methods The medical data of 108 patients with dangerous placenta previa hospitalized in the Department of Obstetrics and Gynecology in Lishui People’s Hospital from October 2016 to October 2018 were retrospectively analyzed.Patients in the control group were treated with Bakri balloon tamponade on the basis of conventional treatment,while patients in the observation group were given mifepristone adjuvant treatment.The general condition of the operation,blood routine and blood gas indexes before and after the operation,and the maternal and infant prognosis of the two groups were recorded and compared.Results The intraoperative blood loss and postoperative blood loss within 24 hours in the observation group were significantly lower than those in the control group(t=4.881 and 8.998,respectively,all P<0.05),and the duration of treatment and hospitalization were significantly shorter than those in the control group(t=6.704 and 3.460,respectively,all P<0.05).The incidence of postpartum hemorrhage in the observation group was significantly lower than that in the control group(P<0.05).There were no statistically significant differences in preoperative Hemoglobin(HB),platelet(PLT),oxyhemoglobin saturation(SpO2)and central venous pressure(CVP)between the two groups(all P>0.05).In the control group,HB,PLT and CVP were significantly decreased after obstetric operation(t=6.128,4.028 and 2.967,respectively,all P<0.05),and HB,PLT and CVP in the control group were significantly lower than those in the observation group(t=5.740,3.707 and 3.150,respectively,all P<0.05).The incidence of puerperal disease in the observation group was significantly lower than that in the control group(P<0.05),the Apgar score of newborns was significantly higher than that of the control group(t=2.990,P<0.05).But there were no statistically significant differences in the hysterectomy rate and the incidence of disseminated intravascular coagulation(DIC)between the two groups(all P<0.05).Conclusion Bakri balloon tamponade combined with mifepristone has good hemostasis effects in the treatment of dangerous placenta previa,which can shorten treatment time and length of hospital stay,effectively maintain the stable vital signs,reduce the incidence of puerperal disease,and improve the prognosis of mothers and babies.