子宫B—Lynch缝合在剖宫产产后出血的运用分析

目的分析子宫B—Lynch缝合在治疗不同原因导致的剖宫产产后出血的应用效果。方法对不同原因导致的31例剖宫产产后出血采用子宫B—Lynch缝合，或合并子宫动脉结扎，或髂内动脉结扎。结果31例子宫B—Lynch缝合在控制不同原因的产后出血中总有效率为77．4％，其中宫缩乏力导致的产后出血23例，单纯使用子宫B—Lynch缝合有效率为82．6％。捆绑缝合后出血仍多加用子宫动脉缝扎或髂内动脉结扎7例，占19．35％。没有子宫切除病例。结论子宫B—Lynch缝合具有操作简单、止血迅速的优点，正确应用能减少出血量，降低输血率，对于难治性产后大出血可合并应用子宫动脉结扎或髂内动脉结扎而达到保全子宫、挽救产妇生命的目的。

Observational Study on B-Lynch Uterine Suture for Postpartum Hemorrhage During Cesarean Section

Objective To analyze the efficacy of B-Lynch suture for postpartum hemorrhage （PPH） during cesarean section. Methods The B-Lynch suture or with uterine artery ligation, or with bilateral internal iliac arteries ligation were done in 31 women with PPH during cesarean section. Results The efficacy of controlling hemorrhage was 77.4%. Among these 31 women, 23 women of PPH were caused by uterine inertia, the efficacy of controlling hemorrhage was 82.6%. The uterine artery ligation, or with bilateral internal iliac interne arteres ligation, was done in seven women （19.35%） who did not respond to the B-Lynch uterine suture. There was no case that was done hysterectomy. Conclusion The technique of B-Lynch suture is a simple technique and can control hemorrhage rapidly. We should use it correctly and reduce blood transfusion. For those severe PPH who we do uterine artery ligation or bilateral internal iliac arteries ligation followed by B-Lynch uterine suture can avoid hysterectomy and survive.