改良式B-Lynch缝扎术在剖宫产术中宫缩乏力性出血的应用.docVIP

改良式B-Lynch缝扎术在剖宫产术中宫缩乏力性出血的应用 【摘要】 目的 探讨改良式B-Lynch缝扎术在 治疗 剖宫产术中、产后出血中的应用价值。方法 改良式B-Lynch缝扎术治疗48例剖宫产术中宫缩乏力性出血为研究组,随机选择30例剖宫产术中宫缩乏力性出血病例作为对照组(采用出血部位“8”字缝扎、结扎双侧子宫动脉、宫腔填塞纱条等方法治疗),在手术时间、产后出血量、产褥病率以及治疗效果等方面对比两组的临床疗效。结果 B-Lynch缝扎术治疗组手术时间、产后出血量、产褥病率以及有效率与对照组比较差异有统计学意义(P0.05)。2组术后子宫缩复、恶露排出正常，未见宫腔粘连。结论 改良式B-Lynch缝扎术具有操作简单、止血迅速、安全易行等优点,治疗剖宫产产后出血效果显著。 【关键词】 剖宫产;宫缩乏力;产后出血;改良式B-Lynch缝扎术 　　Abstract:Objective To explore the value of the application of improved B-Lynch suture technique for intraoperative and postpartum hemorrhage in cesarean section.Methods 48 cases of postpartum hemorrhage caused by uterine inertia in cesarean section treated with the improved B-Lynch suture technique served as the research group, while 30 parturient patients treated with conventional technique for postpartum hemorrhage in cesarean section were recruited as the control group. The operation duration, postpartum hemorrhage volume, puerperal morbidity and therapeutic efficacy between the two groups were compared.Results All cases in the research group were effectively stanched, with preservation of uterine and no occurrence of postoperative complications. The differences in operation duration, hemorrhage volume, puerperal morbidity and success rate between the research group and the control group were statistically significant (P0.05). Both groups had normal uterine involution and discharge of lochia, with no formation of intrauterine adhesions.Conclusion The improved B-Lynch suture technique is particularly effective in the treatment of postpartum hemorrhage in cesarean section for its advantages as simplicity in manipulation, promptness in hemostasis, relative safety and applicability, etc. 　　Key words： cesarean section; uterine inertia; postpartum hemorrhage; the improved B-Lynch suture technique 　　产后出血是产科常见的分娩期并发症，是产妇死亡的主要原因。而宫缩乏力性产后出血又居产后出血的首位。因此，及时处理宫缩乏力性产后出血，对降低产妇病死率极为重要。我院对剖宫产术中宫缩乏力性产后出血的48例患者采用改良式B-Lynch缝扎术，取得了良好止血效果，报道如下。 　 　1 资料和方法 　　1.1 临床资料 我院产科于2007年1月—2008年9月住院分娩总数12752例，其中剖宫产73