B-Lynch缝合对宫缩乏力产后出血妇女的短期和长期影响研究

doi:10．16260/j．cnki．1009 －2188．2017．02．019

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摘要目的探究B-Lynch缝合对宫缩乏力产后出血妇女的短期和长期影响。方法选取2011年2月至2015年2月于我院接受治疗的宫缩乏力产后出血妇女70例，分为观察组和对照组，各35例。观察组行B-Lynch缝合术，对照组行宫腔填塞术。对两组患者进行术后随访，观察两组患者的各阶段临床情况、近期治疗效果以及远期治疗情况。结果在术中、术后、总出血量及输血量方面，观察组与对照组相比差异显著(P＜0．05)。观察组输血和子宫切除的发生率显著少于对照组，观察组止血成功率明显多于对照组，差异具有统计学意义(P＜0．05或P＜0．01)。对两组患者术后并发症发生的情况分析。在术后腹痛、肠粘连、肠梗阻及产褥感染的发生率方面，观察组明显少于对照组，差异具有统计学意义(P＜0．01)。两组患者术后对远期月经周期及月经量的影响无明显差异(P＞0．05)。有12例患者再次妊娠(观察组8例，对照组4例)，观察组有6例成功分娩，对照组1例成功分娩。结论采用B-Lynch缝合术治疗宫缩乏力产后出血的治疗效果好，并发症发生少，能有效保留患者生育能力，值得推广使用。

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	李剑兰，谢如绵，刘绍莲

关键词: 产后出血缝合技术宫缩乏力剖宫产术

Abstract: Objective To explore recent and long term effects of B-Lynch suture on women with postpartum hemorrhage due to uterine inertia．Methods From February 2014 to February 2015，70 cases of uterine postpartum hemorrhage were treated in our hospital．The observation group(35 cases)was treated by B-Lynch suture．The control group(35 cases) received：intrauterine tamponade．The patients were followed up to observe the clinical status，recent effects and long-term effects．ResultsThe incidence of blood transfusion and hysterectomy in the observation group was significantly less than that of the control group，and the number of successful hemostasis in the observation group was significantly higher than that of the control group(P ＜0．05 or P ＜0．01)．The rate of postoperative abdominal pain，intestinal adhesion，intestinal obstruction and puerperal infection was significantly less in the observation group than that of the control group(P ＜0．01)．There were 12 cases got re-pregnant(8 cases of the observation group，and 4 cases the control group)．6 of the observation group got successful delivery，and 1 of the control group got successful delivery． Conclusion B-Lynch suture is cheap，quick and effective in preventing atonic postpartum haemorrhage in women undergoing emergency caesarian section who are at high risk for haemorrhage．

Key words: postpartum hemorrhage suture techniques uterine inertia cesarean section

收稿日期: 2016-11-11 修回日期: 2017-04-07 发布日期: 2018-05-25 期的出版日期: 2017-04-26

ZTFLH:

R719．8

通讯作者: 李剑兰

作者简介: 李剑兰，女，36岁，北海市妇幼保健院妇产科主治医师。

引用本文:

李剑兰，谢如绵，刘绍莲. B-Lynch缝合对宫缩乏力产后出血妇女的短期和长期影响研究[J]. 中国现代手术学杂志, 2017, 21(2): 157-160.
LI Jian-lan. Recent and Long-term Effects of B-Lynch Suture for Atonic Postpartum Hemorrhage. Chinese Journal of Modern Operative Surgery, 2017, 21(2): 157-160.

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http://www.surgerychina.com/CN/10．16260/j．cnki．1009 －2188．2017．02．019 或 http://www.surgerychina.com/CN/Y2017/V21/I2/157

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