B-Lynch缝合术在前置胎盘产妇手术效果及并发症情况分析
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摘要
目的:探讨B-Lynch缝合术对前置胎盘产妇术中、术后及并发症影响。方法:2015年10月—2017年2月本院行治疗的前置胎盘产妇70例,随机分为观察组35例及对照组35例,观察组采用B-Lynch缝合术加宫腔塞纱术止血,对照组采用宫腔塞纱术止血。观察比较两组术中、术后并发症及卵巢基质血流动力指标。结果:两组组缩宫素用量、异常体温时间、血性恶露时间、月经恢复时间及经量比较无差异(P>0.05),但观察组欣母沛用量(240.4±47.8μg)、术中和术后出血量(366.3±79.8ml)、手术时间(34.3±12.6min)及并发症发生率(17.1%)较对照组低(P<0.05)。两组卵巢基质血流动力指标在相同时点比较无差异(P>0.05)。结论:前置胎盘产妇行B-Lynch缝合术加宫腔塞纱术,止血效果明显,对月经恢复无明显影响,术后并发症少,且对卵巢功能影响不大,值得临床应用。
Objective: To explore the influence of B-lynch suture technique on intraoperative and postoperative complications of women with placenta previa. Methods: 70 women with placenta previa were randomly divided into observation group(35 cases) and the control group(35 cases) from October 2015 to February 2017. The women in observation group were treated with B-Lynch suture plus uterine plug gauze for hemostasis, while the women in control group was treated with uterine plug gauze for hemostasis. The rate of intraoperative and postoperative complications, and ovarian matrix hemodynamic indexes of women were observed and compared between the two groups. Results: There were no significant different in oxytocin dosage, time of continual abnormal body temperature, lochia time, menstrual recovery time, and menstrual volume of women between the two groups(P>0.05), while the dosage of hemabate, volume of intraoperative or postoperative bleeding, operation time, and rate of complications of women in observation group were significant lower than those of women in control group(P<0.05). There was no significant difference in ovarian matrix hemodynamics at the same time point between the two groups(P>0.05). Conclusion: B-Lynch suture plus uterine plug gauze for treating women with placenta previa can be hemostasis obviously and can reduce postoperative complications, which has no adverse effect on menstrual recovery and ovarian function. So it is worthy of popularization and application.
Objective: To explore the influence of B-lynch suture technique on intraoperative and postoperative complications of women with placenta previa. Methods: 70 women with placenta previa were randomly divided into observation group(35 cases) and the control group(35 cases) from October 2015 to February 2017. The women in observation group were treated with B-Lynch suture plus uterine plug gauze for hemostasis, while the women in control group was treated with uterine plug gauze for hemostasis. The rate of intraoperative and postoperative complications, and ovarian matrix hemodynamic indexes of women were observed and compared between the two groups. Results: There were no significant different in oxytocin dosage, time of continual abnormal body temperature, lochia time, menstrual recovery time, and menstrual volume of women between the two groups(P>0.05), while the dosage of hemabate, volume of intraoperative or postoperative bleeding, operation time, and rate of complications of women in observation group were significant lower than those of women in control group(P<0.05). There was no significant difference in ovarian matrix hemodynamics at the same time point between the two groups(P>0.05). Conclusion: B-Lynch suture plus uterine plug gauze for treating women with placenta previa can be hemostasis obviously and can reduce postoperative complications, which has no adverse effect on menstrual recovery and ovarian function. So it is worthy of popularization and application.
引文
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[12] 张素兰,冯万成,米岩,等.低位B-Lynch缝合术对前置胎盘剖宫产术月经周期恢复及性激素水平的影响[J].海南医学院学报,2016,22(5):460-462.
[13] 殷思珍,孙瑞勤,杨龙慧.预防性应用卡前列素氨丁三醇联合低位B-Lynch缝合术对前置胎盘术中出血的临床观察[J].实用医学杂志,2015,31(24):4120-4122.
[2] 范丽,高霞,马亚琳.卡前列素氨丁三醇联合低位B-Lynch缝合术治疗难治性前置胎盘性产后出血的临床分析[J].中华妇幼临床医学杂志:电子版,2013,9(2):177-179.
[3] 王秀英.米非司酮联合改良式B-lynch缝合术治疗中央性前置胎盘的临床效果[J].中国计划生育学杂志,2013,21(6):394-396.
[4] 刘晓,于冰.凶险性前置胎盘产前诊断新进展[J].临床医药实践,2014,14(7):534-536.
[5] 乐杰.妇产科学(第7版)(全国高等学校教材)(附光盘)[M].北京:人民卫生出版社,2009:205-236.
[6] 谢幸,苟文丽.妇产科学[M].北京:人民卫生出版社,2014:266-271.
[7] 张志茹,李薇薇,马小红.低位B-Lynch缝合术对前置胎盘剖宫产术及对产后月经的作用分析[J].中国性科学,2013,22(3):30-32.
[8] 张佳.低位B-Lynch缝合术对前置胎盘产妇术后卵巢功能及月经的影响[J].现代中西医结合杂志,2015,24(5):530-531.
[9] 王茜,邢素娟,李友云.B-Lynch缝合术对前置胎盘剖宫产术及产后月经的影响[J].中国妇幼保健,2015,30(5):794-795.
[10] 彭方亮,周晓.凶险性前置胎盘剖宫产术中早期结扎双侧子宫动脉上行支的临床应用[J].重庆医学,2015,44(22):3131-3132.
[11] 朱玉莲,凌静.子宫下段横形环状压迫缝合术治疗前置胎盘剖宫产术中胎盘剥离面出血的临床研究[J].中国妇幼保健,2013,28(23):3751-3753.
[12] 张素兰,冯万成,米岩,等.低位B-Lynch缝合术对前置胎盘剖宫产术月经周期恢复及性激素水平的影响[J].海南医学院学报,2016,22(5):460-462.
[13] 殷思珍,孙瑞勤,杨龙慧.预防性应用卡前列素氨丁三醇联合低位B-Lynch缝合术对前置胎盘术中出血的临床观察[J].实用医学杂志,2015,31(24):4120-4122.
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