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目的分析改良低位B-Lynch缝合术联合宫腔纱布填纱对难治性产后出血的疗效。方法选取我院难治性产后出血孕妇患者108名,36患者采用单纯宫腔纱布填纱止血,36名患者采用低位B-Lynch缝合术,其余36名患者采用改良低位B-Lynch缝合术联合宫腔纱布填纱,分别统计三组患者术后2h内阴道积血量、术后2h-1d累计出血量、产褥感染发生率、子宫切除率和止血成功率,分析三组止血疗效。结果联合止血组止血成功率94.44%,无子宫切除患者,1d后取出纱布未出现再出血,产褥感染引起发烧者2名,抗炎治疗有效,术后定期随访未发现异常,止血疗效明显优于单纯宫腔纱布填纱组和低位B-Lynch缝合术组患者(P<0.05)。结论改良低位B-Lynch缝合术联合宫腔纱布填纱治疗难治性产后出血,止血成功率高,操作简单,降低了子宫切除的风险,有效保留了患者的生育功能,推荐临床应用。
Objective To analyze the curative effect of modified low B-Lynch suture combined with uterine gauze gauze on refractory postpartum hemorrhage. Methods A total of 108 pregnant women with intractable postpartum hemorrhage in our hospital were enrolled. Thirty-six patients were treated with uterine gauze gauze to stop bleeding, 36 patients underwent low B-Lynch suture, and the remaining 36 patients were treated with modified low B-Lynch suture The number of vaginal hemorrhage within 2 hours after surgery, the cumulative amount of bleeding after 2h-1d, the incidence of puerperal infection, the rate of hysterectomy and the success rate of hemostasis were analyzed respectively. The curative effect of three groups was analyzed. Results The success rate of hemostasis in combination hemostasis group was 94.44%. No hysterectomy, no rebleeding occurred in gauze after 1 day, 2 fever caused by puerperal infection, anti-inflammatory treatment was effective, no abnormalities were found after regular follow-up, and hemostasis was better Patients in the uterine gauze packing group and the low B-Lynch suture group (P <0.05). Conclusion Modified low B-Lynch suture combined with uterine gauze filling refractory postpartum hemorrhage, high success rate of hemostasis, simple operation, reducing the risk of hysterectomy, effectively preserving the patient’s reproductive function, and recommended clinical application.