腹腔镜下子宫肌瘤剔除术中联合应用垂体后叶素与呋塞米的临床研究

Effect of Pituitrin Combined with Furosemide during Laparoscopic Hysteromyomectomy

目的探讨腹腔镜下子宫肌瘤剔除术中联合应用垂体后叶素与呋塞米的临床效果。方法80例行腹腔镜下子宫肌瘤剔除术的患者,按就诊日期单双数分为2组,观察组先静脉注射呋塞米20mg,15min后子宫肌层注射垂体后叶素6U。对照组仅注射垂体后叶素。比较2组注射垂体后叶素后5～10min收缩压>150mmHg的例数、术中出血量、手术时间、术后体温>37.5℃的例数。结果所有手术经过均顺利,无中转开腹。与对照组相比,观察组术中出血少[(69.2±16.4)ml与(161.4±23.8)ml,t=-20.336,P=0.000],手术时间短[(70.8±12.2)min与(102.3±34.8)min,t=-5.507,P=0.000],收缩压>150mmHg的患者比例少[26%(11/42)与63%(24/38),χ2=11.078,P=0.001]。2组术后发热比例差异无显著性[21%(9/42)与29%(11/38),χ2=0.602,P=0.438]。结论腹腔镜下子宫肌瘤剔除术中联合应用垂体后叶素与呋塞米,可明显减少术中出血,缩短手术时间。

Objective To observe the effect of pituitrin combined with furosemide on patients undergoing laparoscopic hysteromyomectomy.Methods A total of 80 patients with uterine myoma were divided into two groups according to the consultation date.The observation group included 42 cases,to which pituitrin（6 U）and furosemide（20 mg）were given during laparoscopic treatment.Control group consisted of 38 patients,on whom only pituitrin（6 U）was administered.During the operation,the case number of the patients with high blood pressure（150 mm Hg）and/or high body temperature（37.5 ℃）,as well as the blood loss and operation time of all the cases were recorded.Results All the operations were completed successfully without conversion to transabdominal operation.Compared with the control group,the observation group showed less blood loss [（69.2±16.4）ml vs（161.4±23.8）ml,t=-20.336,P=0.000],shorter operation time [（70.8±12.2）min vs（102.3±34.8）min,t=-5.507,P=0.000],and less patients developed high blood pressure during the procedure [26%（11/42）vs 63%（24/38）,χ^2=11.078,P=0.001].No significant difference was revealed in the case number of high body temperature [21%（9/42）vs 29%（11/38）,χ^2=0.602,P=0.438].Conclusions Pituitrin combined with furosemide is safe and effective in reducing blood loss and operation time during laparoscopic hysteromyomectomy.