改良B-Lynch缝合术治疗剖宫产难治性产后出血的效果  

Effects of modified B-Lynch suture on refractory postpartum hemorrhage during cesarean section

作　　者：张建华[1] 李晓丹 李川川 Zhang Jianhua;Li Xiaodan;Li Chuanchuan(Department of Obstetrics,the Fifth People’s Hospital of Datong,Datong 037000,China)

机构地区：[1]山西省大同市第五人民医院产科,037000

出　　处：《中国实用医刊》2019年第24期65-67,共3页Chinese Journal of Practical Medicine

摘　　要：目的 探讨改良B-Lynch缝合术治疗剖宫产中难治性产后出血的效果。方法 回顾性分析2015年3月至2018年11月在大同市第五人民医院接受治疗的116例剖宫产难治性产后出血患者的临床资料,依据治疗方式的不同分为对照组(宫腔填塞纱布术,58例)与观察组(改良B-Lynch缝合术,58例),比较两组入选者术后出血量、输血量、术后激素水平[雌二醇(E2)、黄体生成素(LH)与卵泡刺激素(FSH)]与并发症发生情况。结果 观察组术后出血量、总出血量及输血量均少于对照组,差异有统计学意义(t=52.523、4.453、6.539,P均=0.000);术后1个月、6个月,两组E2、LH与FSH水平比较,差异未见统计学意义(t=0.100、0.147、0.503、0.105、0.538、0.521,P=0.921、0.884、0.616、0.916、0.591、0.603);观察组并发症发生率(3.45%)低于对照组(15.52%),差异有统计学意义(χ^2=4.921,P=0.027)。结论 剖宫产中难治性产后出血患者通过改良B-Lynch缝合术治疗,可有效控制出血量,降低术后并发症发生率,且不会对性激素水平产生明显影响。Objective To investigate the efficacy of modified B-Lynch suture in patients with refractory postpartum hemorrhage during cesarean section.Methods The clinical data of 116 patients with intractable postpartum hemorrhage after cesarean section treated in the Fifth People’s Hospital of Datong from March 2015 to November 2018 were analyzed retrospectively.According to different treatment methods,the patients were divided into control group(intrauterine packing with gauze,58 cases)and observation group(modified B-Lynch suture,58 cases).The postoperative blood loss,blood transfusion volume,postoperative hormone levels,including estradiol(E2),luteinizing hormone(LH)and stimulating hormone(FSH),and the complications between the two groups were compared.Results The postoperative blood loss,total blood loss and blood transfusion in the observation group were less than those in the control group,the differences were statistically significant(t=52.523,4.453 and 6.539,P=0.000).There were no statistically significant differences in E2,LH and FSH levels between the two groups 1 month,6 months after surgery(t=0.100,0.147,0.503,0.105,0.538,0.521,P=0.921,0.884,0.616,0.916,0.591,0.603).The incidence of complications in the observation group(3.45%)was lower than that in the control group(15.52%),the difference was statistically significant(χ^2=4.921,P=0.027).Conclusions Modified B-lynch suture can effectively control the bleeding and reduce the incidence of postoperative complications in patients with refractory postpartum hemorrhage during cesarean section without significant impact on the level of sex hormones.

关 键 词：难治性产后出血 剖宫产 改良B-LYNCH缝合术 宫腔填塞纱布术 出血量 

分 类 号：R7[医药卫生—临床医学]