改良B—Lynch縫合術(shù)聯(lián)合陰道填紗治療剖宮產(chǎn)后出血的療效及安全性

王茜 王曉秋

【摘要】目的：探討改良B-Lynch縫合術(shù)聯(lián)合陰道填紗治療剖宮產(chǎn)后出血的療效及安全性。方法：選擇在我院住院治療的剖宮產(chǎn)后出血產(chǎn)婦共86例，隨機(jī)分為觀察組和對(duì)照組。觀察組產(chǎn)婦采用改良B-Lynch縫合術(shù)聯(lián)合陰道填紗，對(duì)照組采用球囊壓迫聯(lián)合陰道填紗。觀察兩組產(chǎn)婦的手術(shù)時(shí)間、術(shù)后24h出血量、輸血量、產(chǎn)褥病率、切口恢復(fù)時(shí)間、住院時(shí)間、療效及并發(fā)癥。結(jié)果：觀察組手術(shù)時(shí)間、術(shù)后24h出血量、輸血量均少于對(duì)照組（P<0.05）；觀察組切口恢復(fù)時(shí)間、住院時(shí)間均少于對(duì)照組（P<0.05）；觀察組產(chǎn)褥病發(fā)生率低于對(duì)照組（P<0.05）；觀察組治療有效率明顯高于對(duì)照組（P<0.05）；兩組產(chǎn)婦治療后并發(fā)癥比較無統(tǒng)計(jì)學(xué)差異（P>0.05）。結(jié)論：采用改良B-Lynch縫合術(shù)聯(lián)合陰道填紗治療剖宮產(chǎn)后出血能快速的達(dá)到止血效果，療效顯著，有利于患者恢復(fù)，并發(fā)癥發(fā)生率與傳統(tǒng)方法相當(dāng)，是一種安全有效的治療方法。

【關(guān)鍵詞】剖宮產(chǎn)后出血；改良B-Lynch縫合術(shù)；宮內(nèi)球囊壓迫術(shù)；陰道填紗

Curative effect and security of improved b-lynch combined with vaginal plug yarn on postpartum hemorrhage of cesarean sectionWANG Xi1， WANG Xiaoqiu2. 1.Department of Obstetrics and Gynecology， Longwan District First Peoples Hospital， Wenzhou 325024， Zhejiang， China； 2.Department of Obstetrics and Gynecology， The Third Hospital Affiliated to Wenzhou Medical University， Ruian Peoples Hospital， Wenzhou 325200， Zhejiang， China

【Abstract】Objectives： To discuss curative effect and security of improved B-Lynch combined with vaginal plug yarn on postpartum hemorrhage of cesarean section. Methods： 86 cases of postpartum hemorrhage of cesarean section received the medical treatment in the hospital were selected and divided into observation group and control group randomly. The observation group was given improved B-Lynch combined with vaginal plug yarn， while the control group was given balloon compression combined with vaginal plug yarn. The operation time， amount of bleeding 24 hours after operation， blood transfusion amount， puerperal morbidity， recovery time of incision， length of stay （LOS）， curative effect and complication of two groups were observed. Results： The operation time， amount of bleeding 24 hours after operation and blood transfusion amount of observation group were shorter or less than those in control group （P<0.05）. The recovery time of incision and LOS of observation group were shorter than those in control group. The puerperal morbidity of observation group was lower than that in control group， and the effective rate of observation group was much higher than that in control group. Complication of two groups after medical treatment had no statistical difference. Conclusion： The improved B-Lynch combined with vaginal plug yarn has rapid hemostatic effect on postpartum hemorrhage of cesarean section， with significant curative effect， favorable effect for recovery and comparative occurrence rate of complication， which is a safe and effective treatment method.

【Key words】Postpartum hemorrhage of cesarean section； Improved B-Lynch； Intrauterine balloon tamponade； Vaginal plug yarn

【中圖分類號(hào)】R714.6【文獻(xiàn)標(biāo)志碼】A

剖宮產(chǎn)后出血是產(chǎn)科急重癥之一，其常由于凝血功能障礙、產(chǎn)道損傷、宮縮乏力、胎盤因素等造成[1]。剖宮產(chǎn)后出血如不及時(shí)治療危害較大，可能造成患者切除子宮甚至死亡，有研究顯示其是造成孕產(chǎn)婦死亡的首要病因[2]。以往臨床上常采用宮內(nèi)球囊壓迫術(shù)與陰道填紗治療剖宮產(chǎn)后出血，效果一般，近年來臨床開始采用改良B-Lynch縫合術(shù)治療剖宮產(chǎn)后出血，效果佳[3]。本研究觀察了改良B-Lynch縫合術(shù)聯(lián)合陰道填紗治療剖宮產(chǎn)后出血的療效及安全性，并與宮內(nèi)球囊壓迫術(shù)聯(lián)合陰道填紗治療進(jìn)行比較。現(xiàn)報(bào)告如下。

1資料與方法

1.1一般資料

選擇2013年1月至2015年1月在期間我院住院治療的剖宮產(chǎn)后出血產(chǎn)婦共86例。……