改良式B-Lynch缝合法在剖宫产术中的应用

目的：评价改良式B-Lynch缝合法在剖宫产术中子宫收缩乏力致大出血的止血效果。方法：回顾性分析43例剖宫产术中宫缩乏力致大出血患者,分别采用不同止血方法,观察其止血效果、对比技术易掌握性、评价其实用价值。结果：宫腔纱条填塞13例止血均有效,其中4例术后并发宫腔感染、2例再次大出血;子宫动脉结扎10例,其中8例止血不彻底,加用其他方法;改良式B-Lynch缝合15例,止血效果明显,1例失败;子宫次全切除5例止血彻底,但子宫缺失。结论：剖宫产术中宫缩乏力致大出血时采用改良式B-Lynch缝合法止血,具有止血效果明显、省时、技术简单易行、无需特殊器械、保留子宫等优点,在产科临床中有推广价值。

Application of modified B-Lynch suture in cesarean section

Objective：To evaluate the hemostatic efficacy of modified B-Lynch suture in the massive hemorrhage caused by uterine atony in cesarean section.Methods：After retrospective analysis of 43 patients with massive hemorrhage caused by uterine atony in cesarean section using different hemostatic methods,the hemostatic efficacies were observed,the techniques were compared and the practical values were evaluated.Results：For uterine packing with gauze,all the 13 patients had effective hemostatic efficacy,of which 4 cases were complicated by postoperative intrauterine infection and 2 cases had massive hemorrhage again.Of the 10 patients with uterine artery ligation,8 cases had unsatisfactory hemostatic efficacy and added other methods.15 patients with modified B-Lynch suture had significant hemostatic efficacy,of which only one failed.5 patients with subtotal hysterectomy had satisfactory hemostatic efficacy,but the uterine was absent.Conclusion：Application of modified B-Lynch suture in the massive hemorrhage caused by uterine atony in cesarean section has advantages such as significant hemostatic efficacy,time-saving,easy techiniques and no special equipment,thereby worthy of clinical promotion.