子宫B-Lynch缝合术联合宫腔纱条填塞术在中央性前置胎盘剖宫产术中产后出血的应用

目的:探讨子宫B-Lynch缝合术联合宫腔纱条填塞术(即子宫三明治缝合术)在中央性前置胎盘剖宫产术中防治产后出血中的应用价值。方法:收集我院2014年1月—2016年1月中央性前置胎盘剖宫产术中产后出血患者50例,35例行宫腔纱条填塞术(对照组),15例行子宫B-Lynch缝合术联合宫腔纱条填塞术(观察组),对2组患者术中、术后情况及治疗结果进行分析。结果:观察组术中出血量[(1 140.00±184.00)mL]、输血量[(684.00±118.00)mL]低于对照组[(1 507.11±300.62)mL,(900.00±170.00)mL],差异有统计学意义(均P0.05)。观察组的止血成功率(93.33%)与对照组(82.86%)比较差异无统计学意义(χ~2=0.950,P=0.328)。结论:子宫B-Lynch缝合术联合宫腔纱条填塞术应用于中央性前置胎盘剖宫产术中能够降低出血量及输血量,提高止血成功率,值得临床应用。

The Intrauterine Gauze Packing Combined with B-Lynch Suture in Application of Hemorrhage after Central Placenta Previa in Cesarean Section Postpartum

Objective:To analyze the effect of uterine sandwich method (intrauterine gauze packing combined with B-Lynch suture) to postpartum hemorrhage after central placenta previa in cesarean section. Methods:50 patients of postpartum hemorrhage in cesarean section with central placenta previa form January 2014 to January 2016 at our hospital were collected and divided into observed group (15 cases) and controlled group (35 cases). The controlled group was received intrauterine gauze packing, the observed group was subjected to the uterine sandwich method. The efficiency, intraoperative hemorrhage, amount of blood transfusion, operation time were compared. Results:The intraoperative hemorrhage [(1140.00±184.00) mL] and amount of blood transfusion [ ( 684 . 00 ± 118 . 00 ) mL ] of the observation group were significantly less than that of the control group [(1507.11±300.62) mL, (900.00±170.00) mL] (both P<0.05). The success rate of hemostasis in the observation group (93.33%) was no statistically significant than that in the control group (82.86%) (χ2=0.950, P=0.328). Conclusions:The intrauterine gauze packing combined with B-Lynch suture has the comparative advantage of less intraoperative hemorrhage, less amount of blood transfusion and higher success rate in central placenta previa, is worth promoting.