改良B-Lynch缝合联合宫腔填纱在剖宫产术中难治性出血中的应用

目的:探讨改良B-Lynch缝合联合宫腔填纱在剖宫产术中难治性出血的治疗效果。方法:选择2008年5月～2011年6月剖宫产术中出现难治性出血18例患者,其中前置胎盘12例,胎盘浅植入1例,胎盘早剥子宫卒中2例,宫缩乏力3例。采用改良B-Lynch缝合联合宫腔填纱压迫止血。结果:18例患者均止血成功,24 h取纱未出现再出血。术后体温超过38.5℃2例,超过39℃1例。全部病例术后5～7天出院,产后42天子宫复旧良好。结论:改良B-Lynch缝合联合宫腔填纱控制剖宫产术中难治性出血效果满意,操作简单、安全,保留了患者生育机能,值得临床推广应用。

Application of modified B-Lynch suture combined with filling uterine cavity with gauze in intractable bleeding during cesarean section

Objective:To explore the curative effect of modified B-Lynch suture combined with filling uterine cavity with gauze in intractable bleeding during cesarean section. Methods:Eighteen patients who were found with intractable bleeding during cesarean section from May 2008 to June 2011 were selected,including twelve patients with placenta previa,one patient with shallow placental implantation,two patients with placental abruption and uterine apoplexy,and three patients with uterine inertia.Modified B-Lynch suture combined with filling uterine cavity with gauze was used for hemostasis by compression. Results:Bleeding was stopped in the eighteen patients,gauze was pulled out after 24 hours,and bleeding didn’t appeared.After operation,two patients were found with temperature more than 38.5℃,and one patient was found with temperature more than 39℃.All the patients left the hospital at 5-7 days after operation,involution of uterus was good at 42 days after delivery. Conclusion:The clinical efficacy of modified B-Lynch suture combined with filling uterine cavity with gauze is satisfactory in controlling intractable bleeding during cesarean section,the method is easy to operate and safe,which reserves the reproductive function of the patients and it is worthy to be popularized in clinic.