改良BLynch子宫缝扎术治疗剖宫产产后出血的效果剖宫产胎儿感染B群菌的概率VIP

改良BLynch子宫缝扎术治疗剖宫产产后出血的效果剖宫产胎儿感染B群菌的概率 摘要 目的 探讨改良B-Lynch子宫缝扎术治疗剖宫产产后出血的临床效果。 方法 选取剖宫产产后出血产妇90例，随机分为两组，观察组47例，对照组43例，对照组给予宫腔纱布填塞法，观察组给予改良B-Lynch子宫缝扎术。比较两组患者手术时间、24 h出血量以及术后病率。 结果 观察组患者手术时间为（127.4826.81） s，术后病率为4.26%，明显低于对照组的（202.5637.24） s和37.21%，两组比较差异有统计学意义（P 0.05）。 结论 改良B-Lynch子宫缝扎术治疗剖宫产产后出血有效、及时而安全。 关键词 B-Lynch子宫缝扎术；子宫捆绑术；剖宫产；产后出血 R714.46+1 A 1674-4721（xx）07（c）-0033-02 Effect of modified B-Lynch suture in the treatment of postpartum hemorrhage of cesarean GUO Qiuming The Maternal and Child Care Service Center of Maoming City in Guangdong Province, Maoming 525000, China Abstract Objective To discuss the effect of modified B-Lynch suture in the treatment of postpartum hemorrhage of cesarean. Methods Niy delivery women with postpartum hemorrhage of cesarean were selected and randomly divided into two groups. There were 43 cases in the control group and 47 cases in the observation group. The control group was given the method of intrauterine packing with gauze, while the observation group was given modified B-Lynch suture. The surgery time, blood loss of 24 h and incidence of postoperation were pared between the two groups. Results The surgery time (127.4826.81) s and incidence of postoperation (4.26%) in the observation group were significantly lower than those of the control group (202.5637.24) s and 37.21%, there were statistically significant differences between the two groups (P 0.05). Conclusion Modified B-Lynch suture is an effective, timely and safe treatment method in postpartum hemorrhage of cesarean. Key words Modified B-Lynch suture; Uterine binding method; Cesarean; Postpartum hemorrhage 随着经济社会的发展，越来越多的人选择剖宫产，伴随而来的是诸多并发症，产后出血即是其中之一，严重者可导致死亡1。本研究对47例发生产后出血的剖宫产产妇进行改良B-Lynch子宫缝扎术取得较好效果，现报道如下： 1 资料与方法 1.1 一般资料 选取xx年5月xx年2月本院收治的剖宫产产后出血产妇90例，随机分为两组。其中，观察组47例，年龄2335岁，平均（29.154.24）岁；孕次14次，平均（2.240.53）次；产次13次，平均（1.820.24）次；孕周3741周，平均（38.532.81）周；剖宫产原因：产程停滞14例，臀位13例，胎儿窘迫12例，双胎8例；出血原因：宫缩乏力36例，前置胎盘11例。对照组43例，年龄2233岁，平均（29.684.82）岁；孕次14次，平均（2.370.49）次；产次13次，平均（1.750.29）次；孕周3742周，平均（38.922.25）周；剖宫产原因：产程停滞和臀位各13例，胎儿窘迫11例，双胎6例；出血原因：宫缩乏力33例，前置胎盘10例。所有患者估计出血量均在800 mL左右，且经过热敷、按摩子宫、使用缩宫药物、钙剂等治疗未取得理想效果。两组患者各方面比较差异无统计学意义（P 0.05）。 1.2 方法 1.2.1 对照组 采用宫腔填塞纱布法。自制6 cm2 m4层的纱布，使用碘伏浸透后挤干。自宫底开始使用卵圆钳将纱条排填紧，至子宫切口处时预留一定的长度后将另一端从宫颈口送入阴道内，使用预留的纱条填塞子宫下段，直至全部纱条进入子宫，稍作观察，确认无活动性出血后缝合子宫切口，缝合时应避开纱条。 1.2.2 观察组 采用改良B-Lynch子宫缝合术。快速缝合子宫横切口，将子宫自腹腔内挽出，分别用两根可吸收线连续间断缝合子宫左侧和右侧的前壁、宫底部和后壁的中外1/3交界处，缝制时缝