Objective To explore the clinical value of B-lynch suture in the prevention and control of hemorrhage in cesarean section. Methods The clinical data of 73 cases with high-risk factors of postpartum hemorrhage was retrospectively analyzed. They accepted B-lynch suture at different time in cesarean section or intrauterine packing with gauze. Thirty-five cases accepted B-lynch suture when blood loss ranged from 400 to 500mL( prevention group ), 20 cases accepted it when blood loss was more than 500mL ( treatment group 1 ) and 18 cases accepted intrauterine packing with gauze ( treatment group 2 ). The general effect of haemostasis, mean blood loss, blood transfusion rate, incidence of disseminated intravascular coagulopathy ( DIC ), hospital day and incidence of puerperal disease and involution of uterus after operation were analyzed. Results All of 73 cases obtained satisfactory prevention and control of postpartum hemorrhage, but the prevention group had better effect than two treatment groups. There were statistically significant differences in mean blood loss, mean hospital day, blood transfusion rate, incidence of DIC and that of puerperal disease between prevention group and treatment group 1 ( t value was 10. 19 and 2. 99, respectively, χ2 value was 4.71, 4.71 and 5.76, respectively, all P < 0.05 ). The differences in mean blood loss, mean hospital day, blood transfusion rate, incidence of DIC and that of puerperal disease between prevention group and treatment group 2 were also significant ( t value was 8. 85 and 6.08, respectively, χ2 value was 8. 96, 8. 16 and 16. 12, respectively, all P <0.05 ). Conclusion B-lynch suture is simple, convenient, effective and safe. For patients with high risk of postpartum hemorrhage, postpartum hemorrhage can be prevented and controlled effectively with timely B-lynch suture.%目的 探讨B-lynch缝合术在剖宫产术中预防和控制出血的临床价值.方法 对有产后出血高危因素,在剖宫产术中不同时机施行B-lynch缝合术和宫腔纱条填塞的73例患者的临床资料进行回顾性分析,其中出血为400～<500mL时即预先施行B-lynch缝合术患者35例为预防组;出血量为≥500mL时进行B-lynch缝合术患者20例为治疗组1,进行宫腔纱条填塞18例为治疗组2.观察总体缝合止血效果、平均出血量、输血率、凝血功能障碍发生率、住院天数、产后病率、术后子宫复旧情况,并对结果进行分析.结果 73例患者产后出血均得到预防及满意控制,但预防组效果明显好于两个治疗组,预防组与治疗组1平均出血量、平均住院天数、输血率、弥散性血管内凝血发生率、产后病率差异均有统计学意义(t值分别为10.19、2.99,χ2值分别为4.71、4.71、5.76;均P<0.05);预防组与治疗组2平均出血量、平均住院天数、输血率、弥散性血管内凝血发生率、产后病率差异均有统计学意义(t值分别为8.85、6.08,χ2值分别为8.96、8.16、16.12;均P<0.05).结论 B-lynch缝合术操作简单、迅速、有效、安全,对有产后出血高危因素患者适时实施B-lynch缝合术,其产后出血能得到预防及满意控制.
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