改良B-Lynch缝合法对剖宫产产后出血患者血清性激素水平的影响

Effect of Modified B-Lynch Suture on Serum Sex Hormone Levels in Patients with Postpartum Hemorrhage after Cesarean Section

目的观察改良B-Lynch缝合法治疗剖宫产产后出血患者的临床疗效及对其血清性激素水平的影响。方法将2015年4月—2018年4月行剖宫产且产后出血量超过800 m L的60例患者纳入本研究,依据发病期间治疗方法的不同分为观察组和对照组,每组患者均为30例,对照组实施传统的宫腔纱条填塞法,观察组实施改良B-Lynch缝合法。比较2组临床疗效、临床相关指标及术后并发症发生情况、血清性激素水平状态。结果观察组有效率为86. 67%(26/30),显著高于对照组的63. 33%(19/30),组间比较有统计学差异(P <0. 05);观察组手术时间显著短于对照组,产后24 h出血量显著少于对照组(P <0. 01),但2组术中出血量无统计学差异(P> 0. 05);观察组并发症发生率为6. 67%,与对照组的26. 67%相比呈现显著的降低状态(P <0. 05); 2组E2、FSH及LH等血清性激素水平治疗前和治疗后1个月组内及组间比较均未有统计学差异(P> 0. 05)。结论对剖宫产产后出血量超过800 m L的患者给予改良B-Lynch缝合法可明显缓解其临床症状,且术后并发症发生少,同时不会对机体性激素水平造成影响,效果确切,值得临床推广应用。

Objective To observe the clinical efficacy of modified B-Lynch suture in the treatment of postpartum hemorrhage after cesarean section and its effect on serum sex hormone levels. Methods 60 patients with cesarean section and postpartum hemorrhage exceeding 800 mL from April 2015 to April 2018 were enrolled in this study. They were divided equally into observation group and control group according to different therapies during the onset of disease. The control group underwent conventional intrauterine gauze packing. The observation group were treated with modified B-Lynch suture. 2 groups were compared in view of clinical efficacy, clinical correlation indexes, postoperative complication and serum sex hormone level. Results The effective rate of observation group was significantly higher than that of control group （86.67% vs. 63.33%, P 〈0.05）. The operation time of observation group was significantly shorter than that of control group. The amount of bleeding was significantly lower than that of control group （ P 〈0.01）, but there was no significant difference in intraoperative blood loss between two groups （ P 〉0.05）. We compared the complication rate of observation group （6.67%） with the control group of 26.67%. There was a significant decrease in the ratio （ P 〈0.05）. There was no significant difference in serum sex hormone levels, such as E2, FSH, LH and so on, between the two groups before and 1 month after treatment （ P 〉0.05）. Conclusion The modified B-Lynch suture for patients with cesarean section bleeding over 800 mL can significantly alleviate clinical symptoms and result in fewer postoperative complications, which does not affect body s sex hormone level. The effect is exact and the method is worthy of clinical practice and promotion.