目的 分析剖宫产后难治性子宫出血行子宫压迫缝合术的临床效果。方法 选取2020年1月—2023年6月莆田涵江医院妇产科接诊的85例剖宫产后难治性子宫出血患者为研究对象,进行回顾性研究。依据患者手术治疗方案不同进行分组,以行B-Lynch缝合术治疗者为对照组（42例）,行多U型子宫压迫缝合术治疗者为研究组（43例）。比较两组间手术治疗指标,子宫动脉血流指标,实验室检测指标,止血有效率,术后出血量、月经恢复时间,子宫复旧率,不良预后发生率。结果 相较对照组,研究组行多U型子宫压迫缝合术治疗后,其手术时间,术中出血量,红细胞、血浆输注量,术后止血、住院时间及术后2 h和24 h时出血量,术后月经恢复时间均减少/降低,差异有统计学意义（P<0.05）;术后活化部分凝血活酶时间（APTT）数值降低,实验室红细胞计数（RBC）、血红蛋白（Hb）数值升高,差异有统计学意义（P<0.05）;术后止血率、子宫复旧率升高,子宫切除率、产褥期感染率降低,差异有统计学意义（P<0.05）。结论 相较B-Lynch缝合术,剖宫产后难治性子宫出血患者行多U型子宫压迫缝合术治疗,可在短时间内完成手术、控制出血,实现有效止血。

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.