CAJ | 학술논문

目的：探讨子宫动脉上行支结扎术与B-Lynch缝合术在产后出血中的应用效果。方法回顾性分析2012年1月至2014年1月中国人民解放军第二O二医院妇产科收治的98例因剖宫产术中大出血保守治疗无效而采取手术止血的产妇的临床资料，按照不同治疗方法分为A组(68例)和B组(30例)。 A组采用B-Lynch缝合术治疗， B组采用双侧子宫动脉上行支结扎治疗，上述两种方法无效时，采取子宫切除术。结果 A组成功止血64例(94．12%)、4例患者采取子宫全切或次全切手术治疗，无1例死亡；B组成功止血29例(96．67%)、1例采用次全切手术治疗，无1例死亡。两组产妇手术止血成功率比较差异无统计学意义(P>0．05)。两组产妇术中出血量、输血量、手术时间、住院时间比较差异无统计学意义(P>0．05)。两组产妇术后恶露持续时间、月经复潮时间、第一次月经量、产后月经周期比较差异无统计学意义( P>0．05)。两组产妇产后12个月的FSH、LH、E2水平比较差异无统计学意义( P>0．05)。结论子宫动脉上行支结扎术与B-Lynch缝合术在治疗产后出血中均有较好的止血效果。
목적：탐토자궁동맥상행지결찰술여B-Lynch봉합술재산후출혈중적응용효과。방법회고성분석2012년1월지2014년1월중국인민해방군제이O이의원부산과수치적98례인부궁산술중대출혈보수치료무효이채취수술지혈적산부적림상자료，안조불동치료방법분위A조(68례)화B조(30례)。 A조채용B-Lynch봉합술치료， B조채용쌍측자궁동맥상행지결찰치료，상술량충방법무효시，채취자궁절제술。결과 A조성공지혈64례(94．12%)、4례환자채취자궁전절혹차전절수술치료，무1례사망；B조성공지혈29례(96．67%)、1례채용차전절수술치료，무1례사망。량조산부수술지혈성공솔비교차이무통계학의의(P>0．05)。량조산부술중출혈량、수혈량、수술시간、주원시간비교차이무통계학의의(P>0．05)。량조산부술후악로지속시간、월경복조시간、제일차월경량、산후월경주기비교차이무통계학의의( P>0．05)。량조산부산후12개월적FSH、LH、E2수평비교차이무통계학의의( P>0．05)。결론자궁동맥상행지결찰술여B-Lynch봉합술재치료산후출혈중균유교호적지혈효과。
Objective To investigate the application effect of uterine artery ligation and B - Lynch suture in postpartum hemorrhage. Methods The clinical data of 98 cases in PLA 202 Hospital from January 2012 to January 2014 was retrospectively analyzed, due to postpartum hemorrhage failed to respond to conservative treatment and take surgical hemostasis maternal, according to different treatment methods, the cases were divided into group A(n=68) and group B(n=30). The cases in group A were treated by uterine arcuate artery ligation surgery, The cases in group B were treated by cervical anterior or posterior wall single -layer "U"suture, the above two methods is invalid, with hysterectomy. Results Successful hemostasis in 64 cases of group A (94. 12 %), take hysterectomy or subtotal surgery in 4 cases, no cases died, successful hemostasis in 29 cases of group B (96. 67%),take subtotal surgery in 1 case, no cases died. The difference in patients’ surgical hemostasis successful rate was not statistically significant between two groups (P>0. 05). The difference in blood loss, blood transfusion, operative time, hospital stay were not statistically significant between two groups ( P > 0. 05 ) . The difference in after lochia duration menstruation time, the amount of first menstruation, postpartum menstrual cycle observations were not statistically significant between two groups (P>0. 05). The difference in patients of 12 months postpartum FSH, LH, E2 levels were not statistically significant between two groups ( P>0. 05 ) . Conclusion Uterine artery ligation and B-Lynch suture in the treatment of postpartum hemorrhage were had better hemostatic effect.