子宮動脈上行支結扎聯合B—Lynch縫合術在剖宮產產后出血中的應用

白莉莉

[摘要] 目的 研究子宮動脈上行支結扎聯合B-Lynch縫合術在剖宮產產后出血中的臨床應用價值。 方法 將該院86例剖宮產產后出血患者以隨機數表法分為觀察組與對照組，均為43例，觀察組采取子宮動脈上行支結扎聯合B-Lynch縫合術止血，對照組給予米索前列醇、卡前列素氨丁三醇治療，比較兩組術中、術后出血率，輸血情況及產褥病發生率。 結果 觀察組術中、術后出血量分別為（543.03±206.37）mL、（93.53±28.15）mL，均顯著低于對照組（672.58±310.98）mL、（146.28±85.03）mL，對比差異有統計學意義（P<0.05）。觀察組輸血率、產褥病率分別9.31%、6.98%，顯著低于對照組27.91%、23.26%，對比差異有統計學意義（P<0.05）。 結論 子宮動脈上行支結扎聯合B-Lynch縫合術治療剖宮產產后出血效果顯著，可減少出血量，避免輸血，具有較高的臨床應用價值。

[關鍵詞] 子宮動脈上行支結扎；B-Lynch縫合術；剖宮產；出血

[中圖分類號] R59 [文獻標識碼] A [文章編號] 1674-0742（2015）05（b）-0026-02

Application of Ascending Branch of Uterine Artery Ligation Combined with B-Lynch Suture in Postpartum Hemorrhage of Cesarean Section

BAI Lili

Department of Perinatal Health Care， Hospital of Traditional Chinese Medicine in Luohe ， Luohe， Henan Province， 462000 China

[Abstract] Objective To study the value of clinical application of ascending branch of uterine artery ligation combined with B-Lynch suture technique for postpartum hemorrhage in cesarean section. Methods 86 cases of postpartum hemorrhage of cesarean section patients were divided into observation group （n=43） and control group （n=43） according to random number table method. Ascending branch of uterine artery ligation combined with B-Lynch suture hemostasis was performed in observation group， while misoprostol and carboprost ammonia butyl alcohol three treatment was used in the control group， and hemorrhage rate during and after operation ， the incidence of transfusion and puerperal disease were compared between the two groups. Results In observation group， hemorrhage rate during operation （543.03±206.37） mL and that after operation （93.53±28.15） ml， were significantly lower than those of the control group （672.58±310.98） mL， （146.28±85.03） mL， and the differences were statistically significant （P<0.05）The blood transfusion rate，9.31%， and puerperal morbidity，6.98%， in observation group were significantly lower than those，27.91% and 23.26% ，in control group ， and the differences were significant （P<0.05）. Conclusion The effect of ascending branch of uterine artery ligation combined with B-Lynch suture in treatment of postpartum hemorrhage of cesarean section is remarkable， and it can reduce the amount of bleeding and avoid blood transfusions， so it has high value in clinical application.

[Key words] Ascending branch of uterine artery ligation； B-Lynch suture； Cesarean section； Hemorrhage

產后出血為分娩期常見危重癥，是導致產婦生產死亡的首要因素，同時以剖宮產發生率更高。目前隨著剖宮產臨床數量上升，產后出血的發病率也呈明顯的上升趨勢[1]。以往在常規治療產后出血無效的情況下，不得已采取子宮切除來挽救患者生命，但切除子宮對患者身心有較大的傷害，尤其是有再孕計劃的年輕患者。為研究子宮動脈上行支結扎聯合B-Lynch縫合術在剖宮產產后出血中的臨床應用價值，2011年8月—2014年9月間該院應用子宮動脈上行支結扎聯合B-Lynch縫合術治療剖宮產產后出血并取得良好的臨床效果，現報道如下。

1 資料與方法

1.1 一般資料

整群選取該院收治的86例剖宮產產后出血產婦為研究對象，年齡21～32歲，平均（26.30±4.67）歲；孕周37～42周，平均（39.15±1.31）周；產次1～3次，平均（1.54±0.24）次。剖宮產指征包括產程延長或滯產23例，巨大兒19例，雙胎12例，子癇前期22例，胎盤早剝10例。所選對象均排除血液系統疾病，無其他內外科合并癥。……