高劲松;龚晓明;刘海元;刘俊涛;宋英娜;孙智晶;张颖

• 1:北京协和医院
• 2:北京协和医院妇产科
• 3:北京协和医院妇产科
• 4:北京协和医院妇产科

摘要(Abstract)：

目的：初步评价B-lynch缝合术在治疗及预防产后出血中的有效性。方法：回顾性 分析北京协和医院2006年1月至2012年1月间施行B-lynch缝合术的20例患者的临床资料。 其中，19例为剖宫产分娩时发生产后出血，应用促宫缩剂无效后施行B-lynch缝合术，1例 为有促宫缩剂禁忌证的重症围产期心肌病患者为预防产后出血而行B-lynch缝合术。手术方 法按经典B-lynch缝合术进行。对患者缝合前后出血量、住院期间情况、产后 42 d复查情 况及远期月经情况、再次妊娠情况进行随访。结果：20例患者B-lynch缝合前出血量为 200~4800 ml，中位出血量为 900 ml；缝合后至产后 24 h出血量为50~200 ml，中位出血量 为 100 ml。17例患者单纯行B-lynch缝合后即达到较好的止血效果，3例出血严重患者在缝 合后出血有所减少，但仍加用了子宫动脉缝扎术和（或）子宫动脉栓塞术。所有患者术后及 产褥期复诊均恢复良好；远期随诊有2例月经量减少，1例继发不孕。结论：B-lynch缝合术 是一项简单可靠、并发症少的产后出血保守性手术治疗方法。
Objective：To evaluate the effectiveness of B-lynch suture in treatment and prevention of postpartum hemorrhage. Methods：The clinical data of 20 Cesarean section cases who were admitted to our department from January 2006 to January 2012 were retrospectively analyzed. B-lynch suture was placed in 19 patients due to postpartum hemorrhage and in 1 patient for preventing massive hemorrhage with oxytocin and prostaglandins contraindications. The effectiveness, uterine retracting, and other complications were investigated during the follow-up. Results：The amount of bleeding before and 24 hours after B-lynch suture were 200-4800 ml(median:900 ml) and 50-200 ml(median:100 ml)，respectively. Good hemostatic effect was achieved in 17 patients immediately after the suture procedure. In 3 severe cases, the blood loss declined after the procedure, while other interventions including uterine artery ligation and/or embolization were also applied. All patients recovered well after surgery and during the postpartum follow-up. No specific complication was found. Conclusion：B-lynch suture is a simple and effective surgical technique that can be used to manage postpartum hemorrhage and avoidhysterectomy.

关键词(KeyWords)： |B-lynch缝合术|产后出血|宫缩乏力|保守性手术|
|B-lynch suture|postpartum hemorrhage|uterine atony|conservative operation|

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 高劲松;龚晓明;刘海元;刘俊涛;宋英娜;孙智晶;张颖

Email:

DOI:

参考文献(References)：