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B Lynch缝合术预防剖宫产后出血的临床研究

【摘要】目的:探讨子宫BLynch缝合术对预防有高危因素存在时剖宫产后出血的作用。方法:选择2008年9月~2009年8月在我院行剖宫产,有产后出血高危因素存在的患者,79例为研究组,在术中同时行预防性改良式子宫BLynch缝合;统计我院2007年9月~2008年8月间有产后出血的高危因素存在的剖宫产93例,未行预防性子宫BLynch缝合术,为对照组。比较两组的手术时间、产后出血量、产后出血例数、子宫切除例数等。结果 : 研究组的手术时间长于对照组(P<0.05),但研究组产后出血量、产后出血例数、子宫切除例数明显低于对照组(P<0.05)。结论:子宫BLynch缝合术可用于预防有高危因素存在的剖宫产后出血,且不增加患者住院费用。

  【关键词】 BLynch缝合术;产后出血;剖宫产

  Blynch suture for postpartum haemorrhage

  WU Cuiping, LUO Liqiong, LI Li

  (Department of Gynaecology and Obstetrics, Longhua People's Hospital in ShenZhen, ShenZhen 518000, China)

  [ABSTRACT] Objective: To investigate effects of BLynch suture for the prevention of postpartum haemorrhage in caesarean section cases with high risks. Methods: Blynch suture was performed on 79 caesarean section cases (study group) with high risk of postpartum haemorrhage during September 2008 and August 2009. Data including time spent on the operation, haemorrhage volume, number of hysterectomia and postpartum haemorrhage cases were compared with 93 counterparts (control group) that underwent caesarean section without Blynch suture during September 2007 and August 2008. Result: Though average operation time spent on the study group was longer than that on control group (P<0.05), haemorrhage volume, number of hysterectomia and postpartum haemorrhage cases in the study group were all less than that of the control group (P<0.05). Conclusions: BLynch suture can effectively prevent postpartum haemorrhage in patients underwent caesarean section without increasing hospital expense.

  [KEY WORDS] BLynch suture;Postpartum hemorrhage;Caesarean section

  产后出血是产科常见的分娩期并发症,目前仍居我国产妇死亡原因的首位[1,2],引起产后出血的主要原因为子宫收缩乏力、胎盘因素、软产道损伤及凝血功能障碍,其中以子宫收缩乏力最常见。本文探讨对有产后出血高危因素(如:瘢痕子宫、巨大儿、双胎妊娠、胎盘早剥、产程延长等)存在的剖宫产患者在术中行预防性子宫BLynch缝合术[3],以减少产后出血的发生率,减轻产后出血的严重程度,报道如下。

  1 资料与方法

  1.1 临床资料

  选择2008年9月~2009年8月在我院行剖宫产有产后出血高危因素存在的患者共79例为研究组,在术中同时行改良式子宫BLynch缝合,患者年龄21~39 岁,孕周3

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