改良Hayman缝合术与B-Lynch缝合术联合Bakri球囊填塞在前置胎盘剖宫产产后出血患者中的应用效果比较

Comparison of application effects of modified Hayman suture and B-Lynch suture combined with Bakri balloon tamponade in postpartum hemorrhage after cesarean section of patients with placenta previa

目的:比较改良Hayman缝合术与B-Lynch缝合术联合Bakri球囊填塞在前置胎盘剖宫产产后出血患者中的应用效果。方法:选取2020年7月至2022年7月该院收治的78例前置胎盘剖宫产产后出血患者进行前瞻性研究,按随机数字表法将其分为对照组与观察组各39例。两组均采用Bakri球囊宫腔填塞治疗,在此基础上,对照组联合B-Lynch缝合术治疗,观察组联合改良Hayman缝合术治疗。比较两组手术相关指标水平、康复指标水平和并发症发生率。结果:观察组手术时间、止血时间均短于对照组,术中出血量、术后24 h出血量、输血量均少于对照组,差异有统计学意义(P<0.05);两组术后肛门首次排气时间比较,差异无统计学意义(P>0.05);观察组住院时间、首次下床活动时间、月经恢复正常时间均短于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.13%,低于对照组的25.64%,差异有统计学意义(P<0.05)。结论:改良Hayman缝合术联合Backri球囊填塞应用于前置胎盘剖宫产产后出血患者可缩短住院时间、首次下床活动时间、月经恢复正常时间,降低手术相关指标水平和并发症发生率,其效果优于B-Lynch缝合术联合Bakri球囊填塞。

Objective:To compare application effects of modified Hayman suture and B-Lynch suture combined with Bakri balloon tamponade in postpartum hemorrhage after cesarean section of patients with placenta previa.Methods:A prospective study was conducted on 78 patients with postpartum hemorrhage after cesarean section of placenta previa admitted to this hospital from July 2020 to July 2022.According to the random number table method,they were divided into control group and observation group,39 cases in each group.All patients were treated with Bakri balloon intrauterine tamponade.On this basis,the control group was treated with B-Lynch suture,while the observation group was treated with modified Hayman suture.The levels of surgery-related indicators and rehabilitation indicators,and the incidence of complications were compared between the two groups.Results:The operation time and the hemostasis time of the observation group were shorter than those of the control group,the intraoperative blood loss,postoperative 2 h blood loss and blood transfusion volume were less than those of the control group,and the differences were statistically significant(P<0.05).The hospitalization time,thefirst out-of-bed time and the time for menstruation to return to normal in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 5.13%,which was lower than that in the control group(25.64%),and the difference was statistically significant(P<0.05).Conclusions:The modified Hayman suture combined with Backri balloon tamponade in the patients with hemorrhage after cesarean section of placenta previa can shorten the hospitalization time,thefirst out-of-bed time,the time for menstruation to return to normal,and reduce the levels of operation-related indicators and the incidence of complications.Moreover,it is superior to B-Lynch suture combined with Bakri balloon tamponade.