改良B-Lynch子宫捆绑术治疗剖宫产术中难治性产后出血的效果分析

Comparative study of modified B-Lynch uterine compression suture used for the treatment of severe postpartum haemorrhage

目的研究改良B-Lynch子宫捆绑术治疗剖宫产术中难治性产后出血的效果。方法回顾性分析东莞市大朗医院2009年1月至2012年6月期间剖宫产术中发生的难治性产后出血的33例病例的临床资料。经过按摩子宫、宫体注射缩宮素20U、欣母沛0.25 mg治疗后,根据不同的治疗方法分为两组,病例组行改良B-Lynch子宫捆绑术治疗组,共12例;对照组未行改良B-Lynch子宫捆绑术治疗组,主要治疗方法为宫腔填纱、子宫动脉结扎术,共21例。结果 (1)在干预治疗后出血量、24小时出血量、输血量等指标病例组与对照组的差异有统计学意义(P<0.05);(2)在干预治疗有效率(91.6%vs 76.2%)、干预手术时间、子宫切除率等指标病例组与对照组的差异无统计学意义(P>0.05)。结论改良B-Lynch子宫捆绑术治疗剖宫产术中难治性产后出血效果可靠,干预治疗后出血量少,适合推广应用。

Objective To assess the application of modified B-Lynch uterine compression suture used for the treatment of intractable postpartum hemorrhage. Methods Retrospective analysis was done on the 33 cases of incurable postpartum hemorrhage in Dalang hospital of Dongguan city from January 2009 to June 2003. They were divided into study group （n = 12） and control group （n = 21 ） after massaging of the uterus, intramuscular injection of oxytocin 20U and carboprost 0. 25mg. Cases in study group received modified B-Lynch uterine compression suture. Cases in control group received gauze packing in the uterine cavity and uterine arteries ligation. Results The bleeding volume after intervention treatment, bleeding volume total 24 hours and the amount of blood transfusion in study group was statistical significance than that of control group （P 〈 0. 05）. The effective rate after intervention treatment （91.6% Vs76.2% ）, intervention operation time and the incidence of obstetric hysterectomy in cesarean section in study group was no statistical significance than that of control group （P 〉 0. 05 ）. Conclusions Modified B-Lynch uterine compression suture used for the treatment of severe postpartum haemorrhage have reliable effect, little bleeding volume after intervention treatment, suitability for popularization and application.