子宫背带式缝合对中央性前置胎盘患者剖宫产术中及术后出血的疗效分析

Efficacy of B-lynch suture on intraoperative and postoperative bleeding for patients with central placenta previa

目的探讨子宫背带式缝合对中央性前置胎盘(CPP)患者剖宫产术中及术后出血的疗效。方法纳入2019年1月至2022年8月在资阳市妇幼保健院行剖宫产的CPP患者304例,根据手术方式不同将患者分为研究组106例(子宫下段横切口剖宫产术+子宫背带式缝合术+子宫修补术)及对照组198例(子宫下段横切口剖宫产术或子宫下段横切口剖宫产术+子宫修补术)。比较两组患者术中出血量、术后24小时出血量、住院天数、术后第2天血常规指标及术后并发症的差异。结果与对照组比较,研究组术中出血量及术后24小时出血量明显减少、住院天数明显缩短、术后继发性贫血发生率降低,术后第2天血红蛋白水平升高,差异有统计学意义(P<0.05)。两组止血总有效率差异无统计学意义(P>0.05)。结论与传统缝合方式相比,子宫背带式缝合能有效减少CPP患者剖宫产术中及术后24小时出血量,具有较好的临床应用前景。

Objective To investigate the efficacy of B-lynch suture for intraoperative and postoperative bleeding of patients with central placenta previa(CPP).Methods A total of 304 CPP patients in Ziyang Maternal and Child Hospital from January 2020 to August 2022 were included.According to the operation methods,CPP patients were divided into a study group(n=106)and a control group(n=198).The study group was treated with lower section cesarean section plus B-lynch suture plus uterine repair.The control group was treated with lower section cesarean section or lower section cesarean section plus uterine repair.The intraoperative and 24 hours postoperative bleeding volume,hospital days and postoperative complications were compared between two groups.Results Compared with the control group,the study group had less intraoperative bleeding,less 24 hours postoperative bleeding,less hospital days,lower proportion of secondary anemia and the hemoglobin level was increased on the second day after operation(P<0.05).There was no significant difference in the total effective rate of hemostasis between the two groups(P>0.05).Conclusions B-lynch suture can effectively reduce intraoperative and postoperative 24 h bleeding in CPP patients.It has a good clinical application value.