B-Lynch术与宫腔内水囊压迫结合在难治性产后出血中的应用价值  

Value of B-Lynch in combination with intrauterine sac compression in refractory postpartum hemorrhage

作　　者：陈芳 董媛媛 仝玉珠 高晓琼 白晶[2] Chen Fang;Dong Yuan-yuan;Tong Yu-zhu;Gao Xiao-qiong;Bai Jing(Department of Obstetrics and Gynecology,Xuchang Longhu Hospital,Xuchang 461000,Henan,China;Department of Obstetrics and Gynecology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]许昌龙湖医院妇产科,河南许昌461000 [2]郑州大学第一附属医院妇产科,河南郑州450000

出　　处：《四川生理科学杂志》2024年第1期54-56,92,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨B-Lynch术联合宫腔内水囊压迫在难治性产后出血中的应用效果。方法:回顾性选取2018年3月至2022年1月期间我院收治的100例难治性产后出血患者的临床资料作为研究对象,依据治疗方法不同分为常规组(n=48)与研究组(n=52)。常规组采用宫腔内水囊压迫止血;研究组再常规组的基础上联合B-Lynch术。比较两组止血有效率、围手术期指标(术中出血量、产后恶露持续时间、产后2 h、24 h阴道出血量、止血时间)、术前与术后24 h凝血功能指标(活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)、凝血酶原时间(Prothrombin time,PT)、凝血酶时间(Thrombin time,TT))、应激反应指标(血清醛固酮(Aldosterone,ALD)、肾上腺素(Epinephrine,E)、去甲肾上腺素(Norepinephrine,NE))。结果:研究组止血有效率明显较常规组高,术中出血量、产后2 h、24 h阴道出血量明显较常规组少,产后恶露持续时间、止血时间明显较常规组短(P<0.05);术后24 h,两组APTT、PT、TT均缩短,研究组短于常规组,血清ALD、E、NE水平均下降,研究组低于常规组(P<0.05)。结论:B-Lynch术联合宫腔内水囊压迫止血应用于难治性产后出血中,可改善凝血功能,减轻应激反应,提高止血有效率,减少出血量,促进产后康复。Objective:To investigate the efficacy of B-Lynch combined with intrauterine sac compression in refractory postpartum hemorrhage.Methods:The clinical data of 100 patients with refractory postpartum hemorrhage admitted to our hospital from March 2018 to January 2022 were retrospectively selected as the study subjects,and were divided into the conventional group(n=48)and the study group(n=52)based on different treatment methods.The conventional grou was treated with intrauterine water sac compression for hemostasis;The study group was combined with B-Lynch on the basis of the conventional group.The two groups were compared with hemostatic response rate,perioperative indexes(intraoperative bleeding volume,postpartum lochia duration,vaginal bleeding volume 2 h and 24 h postpartum,hemostasis time),preoperative and 24-hour coagulation function indexes[Activated partial thomboplastin time(APTT),Prothrombin time(PT),Thrombin time(TT)]Stress response indicators[serum aldosterone(ALD),epinephrine(E),norepinephrine(NE)].Results:The effective rate of hemostasis in the study group was significantly higher than that in the conventional group,and the intraoperative bleeding volume,2 h and 24 h postpartum vaginal bleeding were significantly less than those in the conventional group,the duration and hemostasis time of postpartum lochia were significantly shorter than those in the conventional group(P<0.05),and 24 h after surgery,APTT,PT and TT were shortened in both groups,and the serum ALD,E and NE levels were lower in the study group than in the conventional group,and the research group was lower than that in the conventional group(P<0.05).Conclusions:B-Lynch combined with intrauterine sac compression hemostasis in refractory postpartum hemorrhage can improve coagulation function,reduce stress response,improve hemostasis efficiency,reduce bleeding volume,and promote postpartum rehabilitation.

关 键 词：B-Lynch术 宫腔内水囊压迫止血 剖宫产术 难治性产后出血 凝血功能 

分 类 号：R714.461[医药卫生—妇产科学]