改良B—Lynch缝合术用于治疗产后出血的临床应用分析

目的对比研究改良B—Lynch缝合术、B—Lynch缝合术、子宫动脉结扎术在控制产后出血中各自的优缺点。方法介绍改良B—Lynch缝合术并对2007年1月-2010年6月期间应用改良B—Lynch缝合术、B—Lynch缝合术、子宫动脉结扎术治疗产后出血各30例进行比较分析，比较三种止血方法的疗效、并发症等。结果三种手术止血方法均效果显著，实施后出血明显减少，术后均无再次大出血、肠梗阻等严重并发症发生。改良B—Lynch子宫缝合组与B—Lynch子宫缝合组比较：术后腹痛情况、并发症发生率、患者满意度有统计学意义（P〈0．05）；手术时间、术中出血量、需要输血例数及输血量、术后体温、术后恶露量及持续时间、术后子宫复旧情况差异无统计学意义（P〉0．05）。改良B—Lynch子宫缝合组与子宫动脉结扎组比较：手术时间、术中出血量、需要输血例数及输血量、术后恶露量及持续时间、术后患者满意度、术后子宫复旧情况有统计学意义（P〈0．05）；术后腹痛情况、术后体温、术后并发症发生率差异无统计学意义（P〉0．05）。结论改良B—Lynch子宫缝合术是一种简单迅捷、止血效果好、经济成本低、副作用少的控制产后出血的良好方法，值得临床尤其是基层医院推广应用。

Clinical application and analysis on improved B - Lynch uterine suture in control of postpartum hemorrhage

Objective To compare the advantages and disadvantages of improved B - Lynch uterine suture, B - Lynch uterine suture and uterine artery ligation in control of postpartum hemorrhage. Methods The improved B - Lynch uterine suture was introduced, and 30 cases from January of 2007 to June of 2010 for each of improved B - Lynch uterine suture, B -Lynch uterine suture and uterine artery ligation were analyzed,which were performed to prevent postpartum hemorrhage. The therapeutic effect and complication of the three methods were compared. Results The three operative methods of hemostasis were all significantly effective. Hemorrhage was significantly reduced after the operation, and there were no serious complications such as recurrence serious bleeding and intestinal obstruction. The Abdominal Pain, complication and degree of satisfaction of patients after the operation were significantly different between the improved B - Lynch uterine suture and the B - Lynch uterine suture （P 〈 0.05 ）. And the differences between them in the operative time, amount of bleeding, cases of needing blood transfusion, amount of blood transfusion, body temperature, amount and time of lochia, Involution of uterine were not significant（P 〉0. 05）. The differences between the improved B -Lynch uterine suture and uterine artery ligation in the operative time, amount of bleeding, cases of needing blood transfusion, mount of blood transfusion, mount and time of lochia, degree of satisfaction of patients and Involution of uterine were significant（ P 〈 0.05 ）. And between them the abdominal Pain, body temperature and complication were not significantly different （ P 〉 0. 05 ）. Conclusion Improved B - Lynch uterine suture is a good method in control of postpartum hemorrhage, and it is simple and fast, good effect of hemostasis, low cost, few adverse effect. It is worth spreading in the matrical hospital.