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改良式 Anchor B-Lynch 子宫压迫缝合术治疗宫缩乏力性产后出血。

Modified anchored B-Lynch uterine compression suture for post partum bleeding with uterine atony.

机构信息

Obstetrics and Gynecology, Colombo South Teaching Hospital, Kalubowila, Sri Lanka.

出版信息

Acta Obstet Gynecol Scand. 2011 Mar;90(3):280-3. doi: 10.1111/j.1600-0412.2010.01048.x.

Abstract

A prospective observational study was performed to evaluate the performance of a modified uterine compression suturing technique for the management of refractory post partum hemorrhage (PPH) at two leading tertiary referral centers in Colombo, Sri Lanka. An modified anchored B-Lynch suture was done in 17 women with PPH due to uterine atony. In 13 of the women (76%), bleeding was arrested and the uterus conserved. Four women (24%) did not respond to the anchored compression sutures, necessitating emergency post partum hysterectomy. Mean age was 31.2 years. Nine of the women (53%) were primiparous and eight (47%) parous. Mean estimated blood loss was 1994 ml (range 1200-3300 ml). This newly modified anchor B-Lynch compression suture appeared effective in controlling about 75% of PPH due to uterine atony, which allowed uterine conservation. This simple modification can provide a first line surgical step to control PPH.

摘要

一项前瞻性观察性研究在斯里兰卡科伦坡的两家领先的三级转诊中心进行,旨在评估改良子宫压迫缝合术治疗难治性产后出血(PPH)的效果。对 17 例因宫缩乏力导致 PPH 的患者采用改良锚定式 B-Lynch 缝合术。在 13 例患者(76%)中,出血得到控制且子宫得以保留。4 例患者(24%)对锚定式压迫缝合术无反应,需要紧急行产后子宫切除术。患者平均年龄为 31.2 岁。其中 9 例(53%)为初产妇,8 例(47%)为经产妇。平均估计出血量为 1994ml(范围 1200-3300ml)。这种新改良的锚定 B-Lynch 压迫缝合术在控制因宫缩乏力导致的约 75%的 PPH 方面效果显著,从而保留了子宫。这种简单的改良可以作为控制 PPH 的一线手术步骤。

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