改良B-Lynch缝合法在剖宫产产后出血中的临床疗效分析及术后血清性激素水平的探讨

目的:探讨改良B-Lynch缝合法治疗剖宫产时宫缩乏力性产后出血的疗效。方法:选择2004年1月至2009年12月剖宫产产后出血≥800ml患者41例,分为两组,研究组17例,采用改良B-Lynch缝合法止血;对照组24例,采用宫腔填塞纱条法止血,分析比较两组间手术时间、术中术后出血量及术后并发症发生率,同时对改良B-Lynch缝合组术后血清性激素水平随访,将其手术后6周、半年、一年、两年血清性激素水平进行比较,以了解该术式对卵巢功能是否有影响。结果:与改良B-lynch缝合术相比,宫腔填塞纱条操作时间较长(P<0.05),采取措施后至产后24h累计出血量相比,改良B-lynch缝合组较宫腔填塞纱条组显著减少(P<0.05),两组术后并发症比较,差异无统计学意义(P>0.05),患者术后两年血清性激素水平较术后相比较,差异无统计学意义(P>0.05)。结论:改良B-Lynch缝合术能有效止血,操作快捷,易于掌握,是治疗剖宫产时宫缩乏力性产后出血的有效方法之一。

Analysis on clinical efficacy of modified B-Lynch suture in postpartum hemorrhage during cesarean section and exploration on postoperative sex hormones levels in serum

Objective:To explore the clinical efficacy of modified B-Lynch suture in treatment of postpartum hemorrhage caused by uterine atony during cesarean section.Methods:41 women with postpartum hemorrhage (≥800 ml) caused by uterine atony during cesarean section from January 2004 to December 2009 were selected and divided into two group:17 women in study group adopted modified B-Lynch suture to stop bleeding,24 women in control group adopted uterine packing to stop bleeding;the operation times,volumes of intraoperative and postoperative bleeding,postoperative complications in the two groups were analyzed and compared,the levels of sex hormones in serum in modified B-Lynch suture group were followed up and compared among 6 weeks,6 months,one year and two year after operation,in order to understand its effect on ovarian function.Results:The operation time of uterine packing group was longer than that of modified B-Lynch suture group (P < 0.05),the cumulative volume of postpartum hemorrhage between the time point of taking measure and 24 hours after operation in modified B-Lynch suture group was significantly lower than that in uterine packing group (P < 0.05),there was no significant difference in the incidence of postoperative complications between the two groups (P > 0.05),there was no significant difference in sex hormones levels in serum before treatment and after treatment for 2 years (P > 0.05).Conclusion:The modified B-Lynch suture can stop bleeding effectively,which is easy to grasp,simple and quick,and it is an effective method in treatment of postpartum hemorrhage caused by uterine atony during cesarean section.