关键词: 剖宫产, 难治性产后出血, B-Lynch缝合术, 多U型子宫压迫缝合术

Abstract: Objective To analyze the clinical effect of uterine compression suturing surgery on intractable uterine bleeding after cesarean section. Methods A retrospective study was conducted among 85 patients with intractable uterine bleeding after cesarean section at the Obstetrics and Gynecology Department of Hanjiang Hospital in Putian from January 2020 to June 2023. Based on different treatment plans, 42 patients underwent B-Lynch suturing surgery were classified into the control group, and 43 patients underwent multi U-shaped uterine compression suturing surgery were classified into the study group. Surgical treatment indicators, uterine artery blood flow indicators, laboratory indicators, hemostatic efficacy, postoperative bleeding volume, menstrual recovery time, uterine involution rate, and incidence of poor prognosis were compared between the two groups. Results Compared with the control group, the study group who underwent multiple U-shaped uterine compression suturing treatment had significantly reduced surgical time, intraoperative bleeding volume, number of red blood cell （RBC） units transfused, volume of plasma transfused, postoperative hemostasis, hospital stay, bleeding volume at 2 h and 24 h after surgery, and postoperative menstrual recovery time （P<0.05）; reduced postoperative activated partial thromboplastin time （APTT）,and increased RBC count and hemoglobin （Hb） （P<0.05）; increased postoperative hemostasis rate and uterine involution rate, while decreased hysterectomy rate and postpartum infection rate （P<0.05）. Conclusion Compared with B-Lynch suture, multi U-shaped uterine compression suture for patients with intractable uterine bleeding after cesarean section can complete the surgery in a short time, control bleeding, and achieve effective hemostasis.

Key words: Cesarean section, Intractable postpartum hemorrhage, B-Lynch suturing surgery, Multiple U-shaped uterine compression suturing surgery