高危妊娠剖宫产术中应用改良式子宫Hayman缝合术与子宫B-lynch缝合术预防产后出血的临床对照研究

A clinical comparative study on the prevention of postpartum hemorrhage by modified uterine Hayman suture and uterine B-lynch suture during caesarean section in high-risk pregnancy

目的探讨高危妊娠剖宫产术中应用改良式子宫Hayman缝合术与子宫B-lynch缝合术预防产后出血的临床效果。方法选取2019年1月-2021年12月收治的产后宫缩乏力有产后出血倾向的患者35例为对照组,另选2022年1月-2023年8月收治的产后宫缩乏力有产后出血倾向的患者35例为观察组。两组均行子宫下段剖宫产,观察组术中应用改良式子宫Hayman缝合术,对照组术中应用子宫B-lynch缝合术,比较两组治疗有效率、临床指标、输血率、产后出血发生率。结果两组治疗有效率比较差异无统计学意义(P>0.05);两组血性恶露持续时间比较差异无统计学意义(P>0.05);观察组手术时间、止血时间、住院时间均短于对照组,术中、术后2 h及术后24 h出血量均少于对照组(P<0.05);观察组输血率、产后出血发生率均低于对照组(P<0.05)。结论改良式子宫Hayman缝合术与子宫B-lynch缝合术在预防高危妊娠剖宫产产后出血中治疗效果相同,但改良式子宫Hayman缝合术可缩短手术与住院时间,减少术中及术后出血量,降低产后出血并发症发生率,还可降低输血率,值得临床推广与应用。

Objective To investigate the clinical effect of modified uterine Hayman suture and uterine B-lynch suture in preventing postpartum hemorrhage during caesarean section of high-risk pregnancy.Methods A total of 35 patients with postpartum contraction weakness and postpartum bleeding tendency admitted from January 2019 to December 2021 were selected as the control group,and 35 patients with postpartum contraction weakness and postpartum bleeding tendency admitted from January 2022 to August 2023 were selected as the observation group.The lower section of uterus was delivered in both groups.Improved Hayman suture of uterus was used in the study group and B-lynch suture of uterus was used in the control group.The treatment effectiveness,clinical indexes,blood transfusion rate and incidence of postpartum hemorrhage were compared between the two groups.Results There was no significant difference in effective rate between the two groups(P>0.05).There was no significant difference in the duration of lochia hemorrhagic between the two groups(P>0.05).The operation time,hemostatic time and hospital stay of the study group were shorter than those of the control group,and the blood loss during operation,2 h and 24 h after operation was lower than that of the control group(P<0.05).The blood transfusion rate and postpartum hemorrhage rate of the study group were lower than those of the control group(P<0.05).Conclusion Modified Hayman suture of uterus has the same therapeutic effect as B-lynch suture of uterus in preventing postpartum hemorrhage during caesarean section of high-risk pregnancy.However,modified Hayman suture of uterus can shorten the duration of operation and hospitalization,reduce intraoperative and postoperative blood loss,reduce the incidence of postpartum hemorrhage complications,and reduce the blood transfusion rate,which is worthy of clinical promotion and application.