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目的:探讨B-Lynch缝扎术对卵巢功能的影响,寻找一种保留子宫、治疗产后出血的方法,降低子宫切除率,保留生育功能。方法:随访湖州市妇幼保健院自2009年11月以来剖宫产术中产后出血经保守治疗无效、行B-Lynch缝扎术有效止血的28例患者的恶露情况、转经时间、月经情况及生殖激素水平;同时随机选择同期因社会因素单纯行子宫下段剖宫产术的28例患者作为对照。结果:28例行B-Lynch缝扎术的患者术后恶露持续时间、产后第1次月经恢复时间、产后月经量(以产前月经量的增加倍数为标准)、月经周期、行经天数、月经恢复正常量的时间(以月经次数为标准)以及术后第1次月经周期3~5天血清卵泡刺激素(FSH)、黄体生成激素(LH)及雌二醇(E2)水平与单纯行子宫下段剖宫产术的产妇比较均无显著差异(P>0.05),无一例发生卵巢早衰。结论:B-Lynch缝扎术不仅操作简单、迅速、能有效止血、保留子宫,且对卵巢功能无明显影响,无严重近远期并发症,是一种积极有效控制剖宫产产后出血的措施。
OBJECTIVE: To investigate the effect of B-Lynch suture on ovarian function, to find a way to preserve the uterus, treat postpartum hemorrhage, reduce the rate of hysterectomy and keep the function of reproduction. Methods: Follow-up Huzhou MCH hospital since November 2009 after cesarean section in the postpartum hemorrhage conservative treatment ineffective line B-Lynch suture effective hemostasis in 28 patients with lochia situation, menstrual flow, menstrual conditions and Reproductive hormone levels; at the same time randomly selected during the same period due to simple social factors of uterine cesarean section of 28 patients as a control. Results: The duration of postoperative lochia, duration of first postpartum menstruation, postpartum menstrual flow (multiplied by the number of prenatal menstruation), menstrual cycle, menstrual cycle, menstrual cycle (Normal menstruation as the standard) and the first menstrual cycle after 3 to 5 days serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) levels and simple line uterus The lower part of the cesarean section of maternal compared were no significant difference (P> 0.05), no case of premature ovarian failure. Conclusion: B-Lynch suture is not only simple and rapid operation, it can effectively stop the bleeding, retain the uterus, and has no significant effect on ovarian function, without serious short-term and long-term complications. It is a positive and effective measure to control postpartum hemorrhage .