改良B-Lynch缝合术+双侧子宫动脉上行支结扎在剖宫产术中难治性产后出血患者中的应用效果观察

Application of modified B-Lynch suture plus bilateral uterine artery ascending ligation in patients with refractory postpartum hemorrhage during cesarean

目的观察改良B-Lynch缝合术+双侧子宫动脉上行支结扎在剖宫产术中难治性产后出血(PPH)患者中的应用效果。方法回顾性分析医院剖宫产术中难治性PPH患者72例临床资料,依照手术方案不同分为对照组和观察组,每组36例。对照组采用双侧子宫动脉上行支结扎术,观察组采用改良B-Lynch缝合术+双侧子宫动脉上行支结扎术。比较2组手术情况(手术时间、术中出血量、术中输血量)、术后恢复情况(住院时间、月经复潮时间)及子宫切除、产褥热发生率。结果观察组术中出血量、术中输血量少于对照组(P <0. 01);观察组住院时间短于对照组(P <0. 01);2组子宫切除发生率比较差异无统计学意义(P> 0. 05);观察组产褥热发生率为5. 56%,低于对照组的22. 22%(P <0. 05)。结论改良B-Lynch缝合术+双侧子宫动脉上行支结扎治疗剖宫产术中难治性PPH患者,可减少术中出血、输血量及降低并发症发生率,缩短患者住院时间。

Objective To observe the effect of modified B-Lynch suture plus bilateral ascending ligation of uterine artery on patients with refractory postpartum hemorrhage( PPH) during cesarean section. Methods The clinical data of 72 patients with refractory PPH during cesarean section were retrospectively analyzed. They were divided into control group and observation group according to different surgical schemes,with 36 cases in each group. The control group received bilateral uterine artery ascending ligation,and the observation group adopted modified B-Lynch suture plus bilateral uterine artery ascending ligation. The surgical conditions( including operation time,intraoperative blood loss,intraoperative blood transfusion),postoperative recovery( including hospitalization time,menstrual rejuvenation time),and incidence of hysterectomy and puerperal fever were compared between the two groups. Results The amount of intraoperative blood loss and blood transfusion in the observation group were less than those in the control group( P < 0. 01). The hospital stay of the observation group was shorter than that of the control group( P < 0. 01). There was no significant difference in the incidence of hysterectomy between the two groups( P > 0. 05). The incidence of puerperal fever in the observation group was 5. 56%,which was lower than 22. 22% in the control group( P < 0. 05). Conclusion Modified B-Lynch suture plus bilateral ascending ligation of uterine artery for the treatment of patients with refractory PPH during cesarean section can reduce the amount of intraoperative bleeding and blood transfusion,reduce the incidence of complications,and shorten the length of hospitalization.