B-Lynch缝合术预防双胎剖宫产后出血的效果

The effect of B-Lynch suture on bleeding prevention in twins cesarean section

目的探讨B-Lynch缝合术在预防双胎剖宫产后出血的疗效和安全性。方法对2010年1月至2012年6月在湖南省妇幼保健院产科住院113例双胎剖宫产分娩的孕妇进行回顾性研究,将其分为对照组(n=61)和干预组(n=52)。对照组术中未行B-Lynch缝合,干预组术中预防性使用B-Lynch缝合。结果干预组手术时间和出血量分别为52.70±11.06min和675.82±201.23mL,对照组为70.65±13.24min和1 159.46±292.41mL,两组比较差异均有统计学意义(t值分别为15.61、32.15,均P<0.05)。干预组治疗有效率为75.00%(39/52),高于对照组42.62%(26/61),x^2=5.13,P<0.05;干预组的输血、产褥病和切除子宫率均低于对照组(x^2值分别为6.64、3.90、4.35,均P<0.05)。6个月后月经来潮干预组为100.00%(52/52),高于对照组83.61%(51/61),x^2=4.07,P<0.05。结论预防性使用B-Lynch缝合可减少双胎剖宫产后出血的发生。

Objective To explore the efficacy and safety of B-Lynch suture for preventing postpartum hemorrhage in twins cesarean cesarean.Methods A retrospective analysis was conducted on the data of 113 cases of twins pregnancy , who were selected from January 2010 to June 2012 in Maternal and Child Health Hospital of Hunan Province .They were divided into control group （ n =61 ） and intervention group （ n=52 ） .The control group did not undergo B-Lynch suture , while the intervention group adopted B-Lynch suture . Results The operative time and bleeding amount of the intervention group were 52.70 ±11.06min and 675.82 ±201.23mL, respectively, while those were 70.65 ±13.24min and 1159.46 ±292.41mL, respectively in the control group .The difference between two groups was significant（t value was 15.61 and 32.15, respectively, both P〈0.05）.The treatment efficiency of the intervention group was 75.00%（39/52）, which was higher than that of the control group [42.62% （26/61）, （χ^2 =5.13,P 〈0.05）].The incidence of blood transfusion, puerperalism and hysterectomy in the intervention group was lower than that of the control group （χ^2 value was 6.64, 3.90 and 4.35, respectively, all P〈0.05）.In the intervention group, 100% of the patients got menstrual onset within 6 months after cesarean section, which was higher than that of the control group [83.61%（51/61）, （χ^2 =4.07,P〈0.05）].Conclusion Prophylactic use of the B-Lynch suture can reduce the incidence of postpartum hemorrhage after twins cesarean section .