改良B-Lynch缝合术联合阴道填纱治疗剖宫产产后出血的疗效

The Curative Effect of Modified B-Lynch Suture combined with Vaginal Filling in the Treatment of Postpartum Hemorrhage after Cesarean Section

目的探讨改良B-Lynch缝合术联合阴道填纱治疗剖宫产产后出血的疗效。方法选取我院(2013年2月至2018年5月)收治的60例剖宫产产后出血患者为本研究对象,将所有患者根据治疗方法不同分为两组,观察组30例患者给予改良B-Lynch缝合术联合阴道填纱治疗,对照组30例患者给予球囊压迫术联合阴道填纱治疗,观察两组剖宫产产后出血患者临床疗效,对比两组剖宫产产后出血患者出血情况,记录两组剖宫产产后出血患者术后并发症发生情况,包括再出血、宫腔粘连、子宫血液循环不良、疼痛等。结果观察组产妇临床治疗总有效率96.67%明显高于对照组80%,差异具有统计学意义(P<0.05)。观察组产妇术后24h出血量、输血量明显低于对照组,手术时间明显短于对照组,差异具有统计学意义(P<0.05)。观察组产妇切口恢复时间和住院时间均显著快于对照组,差异具有统计学意义(P<0.05)。观察组产妇有2例发生产褥病,产褥病发生率为6.67%,对照组剖宫产产后出血患者有7例发生产褥病,产褥病发生率为23.33%,两组患者产褥病发生率对比差异明显(χ2=8.2157,P<0.05)。对照组产妇并发症发生率13.33%稍高于观察组6.67%,但差异不明显,不具有统计学意义(P>0.05)。结论改良B-Lynch缝合术联合阴道填纱治疗剖宫产产后出血疗效可靠,可迅速止血,降低出血量和输血量,且手术时间更短,更利于患者恢复,同时并发症与传统球囊压迫术联合阴道填纱治疗无明显差异,因此这是一种安全有效的治疗方法,值得临床推广。

Objective To explore the curative effect of modified B-Lynch suture combined with vaginal filling in the treatment of postpartum hemorrhage after cesarean section.Methods In our hospital(February 2013-May 2018)of the 60 cases of postpartum hemorrhage patients as the research object,all patients according to the different treatment methods were divided into two groups,30 patients in observation group were given modified B-Lynch suture combined with vaginal packing treatment,control group of 30 patients treated with surgery combined with balloon compression vaginal filling yarn treatment,observe two groups of patients with postpartum hemorrhage of cesarean section clinical efficacy compared two groups of patients with postpartum hemorrhage of cesarean section bleeding,two groups of cesarean section complications in patients with postpartum hemorrhage,including hemorrhage,intrauterine adhesions,uterine blood circulation,pain etc.Results The total effective rate of 96.67%parturients in the observation group was significantly higher than that of the control group(80%),and the difference was statistically significant(P<0.05).The amount of 24 h bleeding and blood transfusion in the observation group was significantly lower than that of the control group,and the operation time was significantly shorter than that of the control group.The difference was statistically significant(P<0.05).The recovery time of the incision and the time of hospitalization in the observation group were significantly faster than that in the control group,and the difference was statistically significant(P<0.05).In the observation group,2 cases had puerperal disease,the incidence of puerperal disease was 6.67%.In the control group,7 cases had postpartum hemorrhage and 7 cases had puerperal disease.The incidence of puerperal disease was 23.33%.The incidence of puerperal diseases in two groups was significantly different(χ2=8.2157,P<0.05).The incidence of maternal complications in the control group was 13.33%slightly higher than that of the observation group(6.67%),but the difference was not significant(P>0.05).Conclusion The modified B-Lynch suture combined with vaginal packing gauze in treating postpartum hemorrhage curative effect is reliable,can quickly stop bleeding,reduce the amount of bleeding and blood transfusion,and shorter operative time,more conducive to the recovery of patients,no significant difference at the same time,complications and traditional balloon compression surgery combined with vaginal packing treatment,so it is a safe and effective the treatment method,worthy of promotion.