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目的:通过比较规范化培训前后的临床相关指标,分析B-Lynch缝合术规范化培训在临床应用中的指导价值。方法:收集2008年4月至2013年3月在同济大学附属第一妇婴保健院、浦东妇幼保健院及嘉定妇幼保健院实施B-Lynch缝合术的182例单胎、产后出血病例,比较B-Lynch规范化培训前后培训组(145例)和对照组(37例)BLynch缝合前出血量、缝合术后2h出血量、输血率、联合实施子宫动脉上行支结扎术、子宫切除率、宫缩剂使用等指标的差异。结果:与对照组比较,培训组B-Lynch缝合术后2h出血量减少(P<0.05),输血率降低(P<0.05),规范化培训后术者操作时间明显缩短(P<0.001),联合应用子宫动脉上行支结扎术的比率显著降低(P=0.03),宫缩剂卡前列素氨丁三醇(欣母沛)用量显著降低(P=0.044),而卡贝缩宫素(巧特欣)用量无显著差异(P>0.05)。两组的子宫切除率无显著差异(2.1%vs 2.7%,P>0.05)。结论:规范化培训有利于缩短B-Lynch缝合时间,降低缝合术后2h出血量和输血量,并且减少了昂贵缩宫剂的使用,从卫生经济学角度有助于节约医疗费用和资源。
OBJECTIVE: To analyze the clinical value of standardized training of B-Lynch sutures in clinical application by comparing the clinical indexes before and after standardized training. Methods: A total of 182 cases of singleton and postpartum hemorrhage with B-Lynch suture were collected from April 2008 to March 2013 at the First Affiliated MCH Hospital of Pupil, Pudong Maternal and Child Health Hospital and Jiading MCH. B LYNCH standardized training before and after training group (145 cases) and control group (37 cases) BLynch bleeding before suture, 2h after suture bleeding, transfusion rate, the joint implementation of uterine artery ligation, hysterectomy rate, The use of indicators such as the difference. Results: Compared with the control group, the bleeding volume of the training group decreased 2h after B-Lynch suture (P <0.05), the blood transfusion rate decreased (P <0.05), and the operation time of the training group was significantly shortened (P <0.001) The rate of uterine artery ligation was significantly lower (P = 0.03), and the dose of uterotonics cardiotensin (Xinmu Pei) was significantly decreased (P = 0.044) Yan) dosage was no significant difference (P> 0.05). There was no significant difference in hysterectomy rates between the two groups (2.1% vs 2.7%, P> 0.05). Conclusion: Standardized training can shorten the time of B-Lynch suture, reduce the amount of blood transfusion and blood transfusion 2 hours after suture, and reduce the use of expensive uterine decubitus, which helps to save medical costs and resources from the perspective of health economics.