改良B-Lynch缝合术预防高危因素产后出血的临床研究

目的探讨改良B-Lynch缝合术预防高危因素剖宫产产后出血的临床疗效。方法收集宜昌市第一人民医院2007年至2011年实施剖宫产手术时具有产后出血高危因素的患者78例,其中40例采用改良B-Lynch缝合术预防剖宫产产后出血(改良组),38例患者采用常规子宫按摩、宫腔填塞纱条和子宫腔球囊压迫处理(传统组)。分别比较两组患者手术时间、术中出血量、产后出血量及术后恢复情况。结果改良组术后24 h总出血量减少,与传统组相比差异有统计学意义(P<0.05),两组产褥病发生率比较差异无统计学意义(P>0.05),血性恶露持续时间和晚期产后出血发生率比较差异有统计学意义(P<0.01),宫腔粘连发生率比较差异无统计学意义(P>0.05)。结论改良B-Lynch缝合术能有效预防高危因素剖宫产术后出血,降低产后出血发生率,该法应用越早预防出血效果越好,操作简单易学,值得在临床基层推广应用。

The Clinical Effect of Improved B-Lynch Suture Technique for Prevention of Postpartum Hemorrhage with High Risk Factors

Objective To investigate the effect of improved B-Lynch suture for prevention of postpartum hemorrhage with high risk factors. Methods Data of 78 cases with high risk factors for postpartum hemorrhage in Cesarean section surgery from the First People＇s Hospital of Yichang from 2007 to 2011 were collected, including 40 patients receiving modified B-Lynch suture treatment for prevention of postpartum hemorrhage as the improved treatment group ,3g cases treated with normal uterine massage, Uterine cavity filling yarn and uterine cavity balloon compression as the conventional treatment group. The operative time, operative bleeding,postpartum hemorrhage and postoperative recovery of the two groups were analyzed. Results 24 h total postoperative blood loss declined in the improved treatment group, with statistically significant difference （ P 〈 0.05 ） to the conventional treatment group. Puerperalism incidence of the two groups had no statistically significant difference （ P 〉 0.05 ）. The hemorrhagic duration of lochia and incidence of late postpartum hemorrhage had statistically significant difference（ P 〈 0.01 ）, the incidence of intrauterine adhesions had no statistically significant differences（ P 〉 0.05 ）. Conchmion Modified B-Lynch suture technique can effectively prevent the hemorrhage after Cesarean section wth high risks, and reduce the incidence of postpartum hemorrhage;the earlier application of the method, the better the results of preventing bleeding. It＇s simple to operate, thus is worth of popularization and application in clinical.