剖宫产术中大出血采用宫腔填塞与改良B-Lynch缝合术预防治疗的临床探讨

Clinical Study on the Prevention and Treatment of Massive Hemorrhage During Cesarean Section with Uterine Tamponade and Modified B-Lynch Suture

目的探究剖宫产术中大出血采用宫腔填塞与改良B-Lynch缝合术治疗的临床疗效。方法方便选取2017年1月-2019年10月该院剖宫产术中大出血患者60例开展研究。按随机排列法选出30例采用宫腔填塞治疗,列为填塞组;剩余30例采用改良B-Lynch缝合术治疗,列为缝合组;比较两组临床疗效。结果手术情况:缝合组手术时间短于填塞组(P<0.05),术中出血量、术后24 h出血量少于填塞组,差异有统计学意义(P<0.05),D-二聚体水平低于填塞组,差异有统计学意义(P<0.05);术后恢复情况:缝合组术后发热、感染、腹痛发生率均低于填塞组,差异有统计学意义(P<0.05),住院时间短于填塞组,差异有统计学意义(P<0.05);缝合组子宫切除率为0.00%,低于填塞组6.67%,差异有统计学意义(χ^2=6.900,P<0.05)。结论在剖宫产术中大出血采用改良B-Lynch缝合术疗效优于宫腔填塞,可显著减少出血及术后并发症,促进术后恢复,最大限度保留患者的生育功能,改善预后。

Objective To investigate the clinical efficacy of uterine tamponade and modified B-Lynch suture for major bleeding during cesarean section.Methods Convenient selection 60 patients with major bleeding during cesarean section in the hospital from 2017.1 to 2019.10 were included in the study.According to the random arrangement method,30 cases were treated with uterine tamponade and classified as the tamponade group;the remaining 30 cases were treated with modified B-Lynch suture and classified as the suture group;the clinical efficacy of the two groups was compared.Results The operation time was shorter in the suture group than in the stuffing group(P<0.05).The intraoperative blood loss and postoperative blood loss were less than those in the stuffing group(P<0.05);postoperative recovery:the incidence of postoperative fever,infection,and abdominal pain in the suture group was lower than that in the tamponated group(P<0.05),and the length of hospital stay was shorter than that in the tamponated group(P<0.05);the hysterectomy rate of the suture group was 0.00%,which was lower than 6.67%in the stuffing group(χ^2=6.900,P<0.05).Conclusion The use of modified B-Lynch suture for major bleeding during cesarean section is better than uterine tamponade,which can significantly reduce bleeding and postoperative complications,promote postoperative recovery,preserve the patient's reproductive function,and improve the prognosis.