改良B-Lynch缝合术联合宫腔填纱对剖宫产术后宫缩乏力性产后出血患者手术时长及产后出血量的影响

Effect of modified B-Lynch suture and intrauterine filling on length of operation and amount of postpartum hemorrhage in patients with postpartum hemorrhage after cesarean section

目的探讨改良B-Lynch缝合术联合宫腔填纱对剖宫产术后宫缩乏力性产后出血患者手术时长及产后出血量的影响。方法选取2014年1月至2016年12月郑州市第二人民医院治疗的剖宫产术后宫缩乏力性产后出血62例患者,随机数字表法分为观察组和对照组,各31例。对照组采用宫腔填纱治疗,观察组采用改良B-Lynch缝合术+宫腔填纱治疗。统计对比两组手术时长、产后24h出血量以及输血、子宫切除、产褥病率发生情况。结果观察组手术时长、产后24h出血量均少于对照组,差异均有统计学意义(P<0.05);观察组输血率为3.23%(1/31)、子宫切除率为0.00%(0/31)、产褥病率为6.45%(2/31),低于对照组32.26%(10/31)、22.58%(7/31)、41.94%(13/31),差异均有统计学意义(P<0.05);相较于对照组,治疗后观察组物质生活状态、心理、躯体及社会功能评分均较高,差异有统计学意义(P<0.05)。结论联合改良B-Lynch缝合术及宫腔填纱治疗剖宫产术后宫缩乏力性产后出血患者,可缩短手术时长,减少产后出血量,并降低子宫切除率及产褥病率,提高患者生活质量。

Objective To investigate the effect of modified B-Lynch suture and intrauterine filling on the length of operation and the amount of postpartum hemorrhage in patients with postpartum hemorrhage after cesarean section.Methods Totally 62 patients with postpartum hemorrhage after cesarean section from January 2014 to December 2016 in our hospital were selected.They were randomly divided into the observation group and the control group,each with 31 cases.The control group was treated with intrauterine filling,while the observation group was treated with modified B-Lynch suture and uterine cavity filling.The two groups of operation time,24 hours postpartum hemorrhage and blood transfusion,hysterectomy,maturation rate of occurrence were statistically compared.Results The length of operation and the amount of 24 h bleeding in the observation group were less than those in the control group,the difference was statistically significant（P 0.05）.The blood transfusion rate was 3.23%（1/31）,hysterectomy rate was 0%（0/31） and puerperal disease rate was 6.45% in the observation group,which were lower than those of the control group（2/31）,32.26%（10/31）,22.58%（7/31）,41.94%（13/31）,and the differences were statistically significant（P 0.05）.Compared with the control group,the physical status,psychological,physical and social function scores of the observation group were higher than those of the control group（P 0.05）.The difference was statistically significant（P 0.05）.Conclusions The treatment of modified B-Lynch suture combined with intrauterine filling for the patients of postpartum hemorrhage in cesarean section can shorten the length of operation,reduce the amount of postpartum hemorrhage,and reduce the rate of hysterectomy and the rate of puerperal disease and improve the quality of life of patients.