关于B-Lynch子宫缝合术后患者远期并发症及再生育状况调查

A survey on long-term complications and re-pregnancy of patients with B-Lynch after uterine suture

目的关于B-Lynch子宫缝合术后患者远期并发症及再生育状况调查。方法对60例行剖宫产术中出血且采取B-Lynch缝合术治疗患者进行随访,记录B-Lynch缝合术后远期并发症发生情况及患者再生育状况。结果 60例患者随访时间6~71个月,平均随访时间(29.37±7.22)个月。患者月经恢复59例,月经恢复时间3~11个月,平均恢复时间(7.19±2.03)个月,其中月经周期正常56例、月经紊乱3例,另有1例患者术后发生闭经,闭经患者经确诊为席汉综合征所引起的闭经,经激素治疗后有所缓解。60例患者术后无宫腔粘连发生,发生盆腔粘连2例(3.33%),发生子宫内膜异位症患者4例(6.67%)。60例患者均有再妊娠意愿,随访中患者术后均无明显腹痛,且性生活均无影响,再次妊娠23例(38.33%),均为自然受孕,其中2例在随访期结束时仍处于妊娠期,1例妊娠中期引产,8例行人工流产,其余12例均成功分娩。再妊娠时间距离为术后10~58个月,平均时间为(25.39±6.33)个月。2例孕妇发生前置胎盘、2例发生胎盘植入、1例妊娠发生胎盘早剥于妊娠39周突发腹痛,其余无妊娠相关并发症。结论 B-Lynch子宫缝合术后远期并发症发生率较低,且术后对患者生育功能无影响,值得临床推广运用。

Objective To investigate the long-term complications and the re birth of the patients with B-Lynch after uterine suture. Methods 60 cases of cesarean section bleeding and take B-Lynch suture treatment of patients were followed up, the long-term complications after BLynch suture and the patient re birth condition were recorded. Results 60 patients were followed up for 6 months to 71 months, the average follow-up time（29.37±7.22） months. There were 59 cases of menstrual recovery, 3 to 11 months of menstrual recovery and mean recovery time of（7.19 ±2.03） months. Among them, the menstrual cycle was normal in 56 cases, menstrual disorder in 3 cases.1 patient had amenorrhea was diagnosed as Sheehan＇s syndrome, and cured after hormone therapy. There were no cases of intrauterine adhesions in 60 cases, pelvic adhesions occurred in 2 cases（3.33%）, and endometriosis in 4 cases（6.67%）. All of the 60 patients had the intention of re-pregnancy. In the follow-up period, there was no obvious abdominal pain and no effect on sexual life. 23 cases（38.33%） were pregnant again, of which 2 cases were still at the end of the follow-up period during pregnancy, 1 case of mid-pregnancy induction of labor, 8 cases of induced abortion, and the remaining 12 cases were successfully delivered.The mean time of re-pregnancy was（25.39±6.33） months after the operation, which was 10~58 months after operation.2 cases of placenta accrete were founded, 1 case of pregnancy placental abruption occouredsudden abdominal painin 39 weeks of pregnancy, and no other pregnancy-related complica-tion. Conclusion The incidence of postoperative complications after B-Lynch uterus suture is low, and no effect on the fertility of the patients, it is worthy of clinical application.