CAJ | 학술논문

目的：观察剖宫产术中 B-lynch缝合对产后出血的预防效果。方法选择有产后出血高危因素的剖宫产孕妇180例，随机分成 B-lynch缝合组、卡前列素氨丁三醇组和缩宫素组，每组60例。B-lynch缝合组剖宫产术中行子宫B-lynch缝合；卡前列素氨丁三醇组胎盘娩出后宫体注射卡前列素氨丁三醇250μg；缩宫素组胎盘娩出后10 U缩宫素宫体注射，10 U缩宫素加入平衡溶液500 ml中静脉滴注，比较3组子宫收缩、产后出血情况及止血相关费用。结果 B-lynch缝合组及卡前列素氨丁三醇组产后2 h触诊子宫质软所占比例，产后2 h、24 h出血量及产前至产后24 h血红蛋白、红细胞下降值均低于缩宫素组，差异均有统计学意义（ P﹤0.05）；B-lynch 缝合组相关费用显著低于卡前列素氨丁三醇组和缩宫素组，差异亦均有统计学意义（P﹤0.05）。结论对有产后出血高危因素的孕妇，剖宫产术中 B-lynch缝合可减少产后出血的发生，且相对卡前列素氨丁三醇预防产后出血更为经济。
목적：관찰부궁산술중 B-lynch봉합대산후출혈적예방효과。방법선택유산후출혈고위인소적부궁산잉부180례，수궤분성 B-lynch봉합조、잡전렬소안정삼순조화축궁소조，매조60례。B-lynch봉합조부궁산술중행자궁B-lynch봉합；잡전렬소안정삼순조태반면출후궁체주사잡전렬소안정삼순250μg；축궁소조태반면출후10 U축궁소궁체주사，10 U축궁소가입평형용액500 ml중정맥적주，비교3조자궁수축、산후출혈정황급지혈상관비용。결과 B-lynch봉합조급잡전렬소안정삼순조산후2 h촉진자궁질연소점비례，산후2 h、24 h출혈량급산전지산후24 h혈홍단백、홍세포하강치균저우축궁소조，차이균유통계학의의（ P﹤0.05）；B-lynch 봉합조상관비용현저저우잡전렬소안정삼순조화축궁소조，차이역균유통계학의의（P﹤0.05）。결론대유산후출혈고위인소적잉부，부궁산술중 B-lynch봉합가감소산후출혈적발생，차상대잡전렬소안정삼순예방산후출혈경위경제。
Objective To observe the effect of intraoperative B-lynch Suture in prevention and treatment of postpar-tum hemorrhage( PPH)of cesarean section. Methods A total of 180 pregnant women with high risk of PPH undergoing ce-sarean section were randomly divided into B-lynch Suture group(group A,n=60),Carboprost Tromethamine injection group (group B,n=60)and Oxytocin group(group C,n=60). Group A received uterine B lynch saturation during cesarean sec-tion;group B was injected with 250 μg Carboprost Tromethamine injection into uterus after placental expulsion;group C un-derwent intravenously guttae with 10 U Oxytocin added into 500 ml balanced solution after placental expulsion. The situations of uterine contraction,PPH and hemostasis cost in the three groups were compared. Results The radio of mild uterus by postpartum 2 h palpation,the bleeding volumes,and descent values of hemoglobin and red blood cells postpartum 2 h and 24 h in group A and b were significantly lower than those in group C(P﹤0. 05),but the medical cost in group A was significant-ly lower than those in group B and C(P﹤0. 05). Conclusion Intraoperative B-lynch Suture is effective in reducing the inci-dence rate of PPH for the parturients with high risk of PPH,and more cost-effective than those by Carboprost Tromethamine or Oxytocin injections.