Pal Manidip, Biswas Asok Kumar, Bhattacharya Sudhindra Mohan
Vivekananda Institute Of Medical Sciences, Ramakrishna Mission Seva Pratishthan, Kolkata, India.
J Obstet Gynaecol Res. 2003 Oct;29(5):317-20. doi: 10.1046/j.1341-8076.2003.00122.x.
Primary atonic post-partum hemorrhage during lower segment cesarean section, which was not controlled by ecbolics--oxytocin, methylergometrine, 15-methyl-prostaglandinF2alpha--was managed by applying a B-Lynch Brace Suture. The test of potential efficacy was the control of hemorrhage by bimanual uterine compression. Six primigravida patients at their term gestation, who underwent emergency cesarean section, all except one under spinal anesthesia, received this type of suture. Interestingly, in every case hemorrhage was controlled successfully with the compression suture. None of them received blood or blood products transfusions or developed disseminated intravascular coagulopathy. Postoperative recovery was good and all patients are in follow-up to assess their future reproductive activity. B-Lynch Brace Suturing is an invaluable procedure for the control of atonic primary post-partum hemorrhage following cesarean delivery.
下段剖宫产术中发生原发性宫缩乏力性产后出血,使用催产剂(催产素、甲基麦角新碱、15-甲基前列腺素F2α)未能控制出血,遂采用B-Lynch子宫缝扎术处理。潜在疗效的检验方法是通过双手压迫子宫来控制出血。6例足月妊娠初产妇接受了急诊剖宫产,除1例采用脊髓麻醉外,其余均接受了这种缝合术。有趣的是,在每一例中,压迫缝合术均成功控制了出血。她们均未接受输血或血液制品输注,也未发生弥散性血管内凝血。术后恢复良好,所有患者均在接受随访以评估其未来的生殖活动。B-Lynch子宫缝扎术是控制剖宫产术后原发性宫缩乏力性产后出血的一项非常有价值的手术。