目的 探讨结扎子宫动脉上行支联合B-Lynch缝合治疗剖宫产术中大出血中应用的疗效和安全性.方法 回顾性分析北京市房山区中医医院2006年1月~2011年12月剖宫产术中出血16例实行结扎子宫动脉上行支联合B-Lynch缝合治疗的患者资料.观察术中出血量、产后出血率及产褥病率的发生情况.对患者出院后子宫复旧、阴道出血量、恶露的性质、月经复潮及再次妊娠状况等进行随访.结果 全部保留了子宫,未发生术后并发症.术后42 d随访所有病例子宫复旧良好,无晚期出血.结论 结扎子宫动脉上行支联合B-Lynch缝合治疗剖宫产术中大出血,止血迅速,成功率高,是基层医院治疗产后出血行之有效的方法.%Objective To investigate the efficacy and safety of uterine artery ascendant branch ligation combined B-Lynch suture in treatment of intraoperative hemorrhage in cesarean section. Methods The clinical data of 16 patients who were found with intraoperative hemorrhage in cesarean section and treated with uterine artery ascendant branch ligation combined B—Lynch suture from January 2006 to December 2011 were analyzed tretrospectively. The intraop-eratve blood loss, postpartum hemorrhage rate, puerperal morbidity of all patients were observed. After discharge, the uterine involution, vaginal bleeding amount, lochia nature, return of menses and subsequent pregnancy status were followed-up. Results All patients retain the uterus, and there was no postoperative complications. 42 days follow-up after operation showed that uterine involution was good, and no late bleeding was found. Conclusion Uterine artery ascendant branch ligation combined B-Lynch suture in treatment of intraoperative hemorrhage in cesarean section can stop bleeding quickly, the success rate is high, and it is effective treatment method of postpartum hemorrhage in primary hospital.
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