改良式B-lynch缝合术在剖宫产产后出血中的应用

Clinical application of modified B-lynch suture technique in postpartum hemorrhage after cesarean section

目的探讨改良式B-lynch缝合术在剖宫产产后出血中的临床应用效果。方法将2005年1月至2011年12月收治的67例剖宫产产后出血患者随机分为两组,其中观察组34例采用改良式B-lynch缝合术;对照组33例采用宫腔填塞纱布止血。比较两组止血效果及术后并发症发生情况。结果观察组34例患者中成功32例,成功率为94.1%;术后无弥散性血管内凝血(DIC)的发生,无子宫切除或二次手术,无并发症的发生。对照组33例患者中成功30例,成功率为90.9%。两组患者手术时间,术中、术后出血情况,手术成功率,抗菌药物的选择等比较,差异均无统计学意义(P>0.05);对照组发生术后并发症3例(9.1%),与观察组(0.0%)比较,差异有统计学意义(χ2=8.23,P<0.01)。结论改良式B-lynch缝合术具有操作简单、止血迅速、有效保留子宫、并发症少、成功率高等优点,是治疗剖宫产产后出血行之有效的止血方法。

Objective To explore the clinical application of modified B-lynch suture in postpartum hemorrhage after ce-sarean section. Methods Totally 67 patients with postpartum hemorrhage after cesarean section from January 2005 to December 2011 were randomly divided into the observation group（n=34） and the control group（n=33）. The observation group was treated with modified a B-lynch suture technique,and the control group was subject to intrauterine packing with gauze to stop bleeding. The hemostatic effect and the postoperative complications between the two groups were compared. Results Among the 34 patients in the observation group,32 cases were successful with the success rate of 94.1%,and no postoperative disseminated intravascular coagulation（DIC）,hysterectomy or secondary surgery occurred. Among the 33 patients in the control group ,30 cases were of suc-cess with the success rate of 90.9%. The operation time,intraoperative and postoperative bleeding,surgical success rate,the choice of antimicrobial difference between the two groups had no statistically significant difference （P〉0.05）. The postoperative complications was 3 cases（9.1%） in the control group,comparing with the observation group（0.0%）,the difference was statistically significant（χ2=8.23,P〈0.01）. Conclusion Modified B-lynch suture technique is simple to operate,quick to stop bleeding,it preserves the uterus effectively with few complications and high success rate ,so it is an effective way for haemostasis after cesarean section.