腹腔镜下子宫肌壁间肌瘤核除术中应用垂体后叶素的临床效果分析

The clinical effect of pituitrin on laparoscopic intramural hysteromyoma

目的分析腹腔镜下子宫肌壁间肌瘤核除术中应用垂体后叶素的临床效果,探讨其应用价值。方法选择60例行腹腔镜下子宫肌壁间肌瘤核除术的患者,随机分为3组,治疗组采用垂体后叶素6U+0.9%氯化钠注射液9mL子宫肌层注射;缩宫素组缩宫素10U+0.9%氯化钠注射液9mL子宫肌层注射;对照组0.9%氯化钠注射液10mL子宫肌层注射。分析各组用药前后的血压变化、术中出血量、手术时间、术后体温及并发症。结果所有手术经过均顺利,无中转开腹。治疗组及缩宫素组与对照组相比,术中出血量明显减少,手术时间明显减少(P<0.01),其中,治疗组出血量最少(P<0.01),手术时间最短(P<0.01)。术中用药后15min,治疗组收缩压上升,显著高于缩宫素组与对照组(P<0.05、P<0.01),用药后30min和45min后,治疗组血压与缩宫素组、对照组比较,无显著性差异(P>0.05)。治疗组与缩宫素组、对照组比较,术后体温、并发症均无显著性差异(P>0.05)。结论腹腔镜下子宫肌壁间肌瘤核除术中应用垂体后叶素,可明显减少术中出血,减少手术时间,效果优于催产素,值得推广应用。

Objective To analyze the clinical effect of pituitrin on laparoscopic intramural hystemmyoma, and investigate the clinical value. Methods Sixty patients undergoing laparoscopic intramural hysteromyoma were randomized into three groups, received pituitrin 6 U ＋ normal saline 9 mL （ treat group, n = 20）, oxytocin 10U ＋ normal saline 9 mL （oxytocin group, n = 20） or normal saline 10 mL （control group, n = 20） injection into uterine muscle separately. The blood pressure, bleeding volume, operation time, body temperature after operation and complications before and after the treatment were observed. Results All the operations were successful, without transferring to trans-abdominal operation. The bleeding volume of treat group and oxytocin group were significantly smaller than that of control group （P 〈 0.01 ）, The operation time of treat group and oxytocin group were significantly shorter than control group （P 〈 0.01）, which was the shortest in treat group （P〈 0.01）. The blood pressure increased 15 min after pituitrin injection in treat group, which was significantly higher than that of oxytocin and control group （P〈 0.05, P 〈 0.01）. There was no significant difference in blood pressure increasing after 30, 45 rain in treat group, without significant difference between oxytocin group and control group （P 〉0.05）. There was no difference in body temperature after operation and complications a- mong three groups （P 〉 0.05）. Conclusion Injection of pituitrin in laparoscopic intramural hysteromyoma can decrease the blood loss and shorten operation time, which is better than injection of oxytocin.