Abstract: Background   At present， there are many hemostasis methods for placenta previa complicated with postpartum hemorrhage. Compared with other methods， Balloon packing compression hemostasis is simple， non-traumatic and has obvious hemostasis effect.Objective　To explore the efficacy of intrauterine tamponade with Cook balloon（a double balloon device） versus Bakri balloon on hemorrhage from the lower uterine segment due to placenta previa during the cesarean section.Methods　From Hebei General Hospital，we recruited 78 cases who had hemorrhage from the lower uterine segment due to placenta previa in the cesarean section during January 2012 to January 2018，42 of whom were treated with intrauterine tamponade with Cook balloon（Cook balloon tamponade group），and other 36 were treated with intrauterine tamponade with Bakri balloon（Bakri balloon tamponade group）．The intraoperative indicators（duration of operation，time-to-hemostasis，blood loss during operation，rate of achieving effective hemostasis，blood transfusion rate），and postoperative indicators （total amount of bleeding within 24 hours after operation，duration of antibiotic therapy，rate of postoperative infections，and length of hospital stay） in the two groups were compared.Results　There were no significant differences between the two groups in the average duration of operation，rate of achieving effective hemostasis，and blood transfusion rate（P>0.05）．The average time-to-hemostasis，and average blood loss during operation in Cook balloon tamponade group were significantly less compared with those of Bakri balloon tamponade group（P<0.05）．Furthermore，the average total amount of bleeding within 24 hours after operation was also obviously less in Cook balloon tamponade group compared with that of Bakri group（P<0.05）．However，the average duration of antibiotic therapy，rate of postoperative infections，and average length of hospital stay showed no significant differences between the two groups（P>0.05）.Conclusion　Compared with those using Bakri balloon tamponade，patients used Cook balloon tamponade had less average amount of bleeding within 24 hours after operation，although both groups had similar average duration of operation，duration of antibiotic therapy，rate of postoperative infections and length of hospital stay，indicating that Cook balloon tamponade has better hemostatic effect.

Key words: Uterine hemorrhage, Uterine tamponade, Cesarean section, Placenta previa, Postpartum hemorrhage, COOK double-balloon

摘要： 背景　目前用于前置胎盘合并产后出血的止血方法较多，相对于其他方法，球囊填塞压迫止血操作简便、无明显创伤，止血效果明显。目的　比较COOK双球囊宫腔填塞与Bakri球囊宫腔填塞对前置胎盘剖宫产术子宫下段出血的疗效。方法　回顾性选取河北省人民医院2012年1月—2018年1月因前置胎盘行剖宫产术术中发生子宫下段出血患者78例，其中应用COOK双球囊宫腔填塞压迫止血42例（双球囊组），Bakri球囊宫腔填塞压迫止血36例（单球囊组）。比较两组术中指标（手术时间、止血时间、术中出血量、止血有效率、输血率）、术后指标（术后24 h出血量、抗生素应用时间、术后感染率、住院天数）的差异。结果　两组手术时间、止血有效率和输血率比较，差异无统计学意义（P>0.05）；双球囊组术中出血量和止血时间少于单球囊组（P<0.05）。双球囊组术后24 h出血量少于单球囊组（P<0.05）；两组抗生素应用时间、术后感染率、住院天数比较，差异无统计学意义（P>0.05）。结论　COOK双球囊宫腔填塞对前置胎盘剖宫产术子宫下段出血的止血效果优于Bakri球囊宫腔填塞，术后出血少，且不增加手术时间、抗生素应用时间、术后感染率及住院时间。

关键词: 子宫出血, 宫腔填塞, 剖宫产术, 前置胎盘, 产后出血, COOK双球囊