剖宫产术中应用B-Lynch缝合术预防产后出血的研究

B-Lynch suture at caesarean section for management of postpartum hemorrhage

目的：探讨具有产后出血高危因素的产妇在剖宫产术中应用B-Lynch缝合术预防产后出血的效果。方法回顾性分析2008年7月~2010年7月间在广州市妇女儿童中心行剖宫产分娩的92名有产后出血高危因素的产妇，按照术中是否施行B-Lynch分为研究组（n=44）和对照组（n=48），比较两组产妇的术中失血量，产后24小时失血量，术前术后血红蛋白差值、晚期产后出血例数。结果研究组剖宫产术中失血量，产后24小时失血量及术前术后血红蛋白差值均显著低于对照组（t=2.790，P=0.008；t=-2.867，P=0.010；t=-4.117，P=0.001）；研究组产妇产后出血发生率显著低于对照组（χ2=3.97，P=0.046）。结论 B-Lynch缝合术是一种在预防剖宫产术中及产后出血方面的简单、安全、可避免子宫切除的保守性手术。

Objective To evaluate the effect of B-Lynch suture in women who have high risk factors of postpartum hemorrhage during caesarean section. Methods A retrospective survey was conducted in 92 patients with high risk of postpartum hemorrhage, including 44 patients had the B-Lynch sutures performed (study group) and 48 patients did not (control group) during the caesarean section frome July 2008 to July 2010 at our hospital. The total amount of blood loss during the surgery and the first postpartum 24 hours, hemoglobin difference between pre-operation and postoperation and late postpartum hemorrhage of the two groups were compared. Results The total amount of blood loss during surgery and the first postpartum 24 hours and hemoglobin difference between pre-operation and postoperation of the study group were significantly less than control group ((t=2.790, P=0.008; t=-2.867, P=0.010; t=-4.117, P=0.001); incidence of postpartum hemorrhage of the study group were significantly less than control group (χ2=3.97, P=0.046). Conclusions B-Lynch suture procedure was a simple, safe and effective method on prevention of hemorrhage during operation and postpartum hemorrhage, and could refrain from hysterectomy.