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改良式 B-Lynch 缝合术在预防双胎妊娠剖宫产术中子宫底部和部分子宫体出血中的临床效果分析:一项回顾性研究。

Clinical outcome analysis of modified B-Lynch sutures in the fundus uteri and part of the corpus uteri for the prevention of intraoperative haemorrhage during caesarean delivery in women with twin pregnancy: a retrospective study.

机构信息

Department of Obstetrics and Gynecology, Ningbo Women and Children's Hospital, Ningbo, 315012, Zhejiang, China.

Radiology Department, Ningbo Women and Children's Hospital, Ningbo, 315012, Zhejiang, China.

出版信息

BMC Pregnancy Childbirth. 2023 Jun 9;23(1):428. doi: 10.1186/s12884-023-05759-3.

Abstract

OBJECTIVE

To explore the efficacy of modified B-Lynch sutures in the fundus uteri and part of the corpus uteri for the prevention of intraoperative haemorrhage during caesarean delivery in women with twin pregnancy.

METHODS

This retrospective analysis covers the clinical data of 40 women with postpartum haemorrhage caused by uterine inertia during caesarean section in women with twin pregnancy in our hospital from January 2018 to May 2022. These women were divided into the group with modified B-Lynch sutures at the fundus and part of the corpus uteri (Group A, 20 patients) and the group with classic B-Lynch sutures (Group B, 20 patients) according to the treatment received. The treatment effect and safety of the two uterine compression sutures were compared.

RESULTS

In this study, no statistically significant differences were found in the outcomes of haemostasis or intraoperative and 24-h postoperative blood loss between the two uterine compression suture groups (P > 0.05). Compared to Group B, Group A showed a significantly reduced operative time, postoperative hospital stay, puerperal morbidity rate, pain score and duration of lochia.

CONCLUSION

Modified B-Lynch sutures at the fundus and part of the corpus uteri can achieve a haemostatic effect similar to that of the classic B-Lynch suture, while it allows for a shortened operative time and reduced postoperative complications. Modified B-Lynch sutures can serve as a safe, rapid and effective haemostatic method for the prevention and treatment of postpartum haemorrhage during caesarean section in women with twin pregnancy, showing certain validity for promotion in clinics.

摘要

目的

探讨改良式 B-Lynch 缝线在子宫底及部分子宫体预防双胎妊娠剖宫产术中出血的效果。

方法

回顾性分析我院 2018 年 1 月至 2022 年 5 月收治的 40 例双胎妊娠剖宫产术中宫缩乏力性产后出血患者的临床资料,将其分为改良式 B-Lynch 缝线子宫底及部分子宫体组(A 组,20 例)和经典式 B-Lynch 缝线组(B 组,20 例),比较两种子宫压迫缝合术的治疗效果及安全性。

结果

本研究中,两组患者的止血效果或术中及术后 24 h 出血量比较,差异均无统计学意义(P>0.05)。与 B 组比较,A 组手术时间、术后住院时间、产褥病率、疼痛评分及恶露持续时间均明显缩短。

结论

改良式 B-Lynch 缝线子宫底及部分子宫体可达到与经典式 B-Lynch 缝线相似的止血效果,且可缩短手术时间,减少术后并发症,可作为一种安全、快速、有效的止血方法,用于预防和治疗双胎妊娠剖宫产术中宫缩乏力性产后出血,在临床上具有一定的推广价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e23/10251635/d302318e5a72/12884_2023_5759_Fig1_HTML.jpg

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