摘要
目的难治性产后出血是产科较为严重的并发症之一,是导致产妇子宫切除与死亡的主要原因。本研究探讨改良B-Lynch缝合术对难治性产后出血患者出血量及子宫切除率的影响。方法回顾性分析2018-01-06-2019-02-08河南圣德医院收治的60例难治性产后出血患者临床资料,将行子宫动脉结扎术的30例患者作为对照组,行改良B-Lynch缝合术的30例患者作为观察组。对比两组手术疗效、出血量、临床相关指标、术后并发症及子宫切除率。结果观察组子宫切除率为6.67%,低于对照组的26.67%,差异有统计学意义,χ~2=4.320,P=0.037;观察组手术总有效率为96.67%,高于对照组的73.33%,差异有统计学意义,χ~2=4.706,P=0.011;观察组术后1、6和12h出血量均低于对照组,差异有统计学意义,均P<0.05;观察组手术时间(t=5.797,P<0.001)、止血时间(t=8.098,P<0.001)、下床活动时间(t=5.047,P<0.001)和住院时间(t=3.742,P<0.001)均低于对照组,差异有统计学意义;观察组并发症发生率为10.00%,低于对照组的33.33%,差异有统计学意义,χ~2=4.812,P=0.028。结论实施改良B-Lynch缝合术可有效降低难治性产后出血患者的出血量及子宫切除率,减少产后并发症。
OBJECTIVE Intractable postpartum hemorrhage is one of the more serious complications in the department of obstetrics,which is the main cause of maternal hysterectomy and death.Therefore,this paper aims to investigate the effect of improved B-Lynch suture on bleeding volume and hysterectomy rate in patients with intractable postpartum hemorrhage.METHODS The clinical data of 60 patients with intractable postpartum hemorrhage admitted in the hospital from January 6,2018 to Februay 2,2019 were retrospectively analyzed.30 patients with uterine artery ligation were taken as control group,and 30 patients with improved B-Lynch suture were taken as observation group.The surgical efficacy,bleeding volume,clinical indexes,postoperative complications,hysterectomy rate were compared between the two groups.RESULTS The hysterectomy rate of observation group(6.67%)was lower than that of control group(26.67%),and the difference was statistically significant(P=0.037).The total effective rate of observation group(96.67%)was higher than that of control group(73.33%),and the difference was statistically significant(χ~2=4.706,P=0.011).The intraoperative bleeding volume,postoperative 1 h,6 h,and 12 hbleeding volume in observation group were lower than those in control group,and the difference was statistically significant(all P<0.05).The operation time,hemostasis time,off-bed activity time,hospital stays in observation group[(57.95±8.23)min,(14.58±2.63)min,(2.68±1.25)d,(6.24±2.04)d]were lower than those in control group,and the difference was statistically significant(all P<0.01).The incidence of complications in observation group(10.00%)was lower than that in control group(33.33%),and the difference was statistically significant(χ~2=4.706,P=0.028).CONCLUSIONS Improved B-Lynch suture for patients with intractable postpartum hemorrhage can effectively decrease bleeding volume and hysterectomy rate,reduce postpartum complications,increase clinical effective rate,and promote rehabilitation,which is worthy of clinical promotion and application.
作者
陈荣秀
冯丽丽
CHEN Rong-xiu;FENG Li-li(Department of Gynaecology and Obstetrics,Henan Shengde Hospital,Xinyang464000,P.R.China)
出处
《社区医学杂志》
2019年第10期603-605,共3页
Journal Of Community Medicine
