腹腔镜子宫肌瘤切除术中减少出血方法的临床研究

Clinical study on reducing the bleeding in laparoscopic myomectomy

目的比较手术前直肠给药米索前列醇和短期口服米非司酮对减少腹腔镜下子宫肌瘤切除术出血的临床疗效。方法选取96例腹腔镜下子宫肌瘤切除术患者,随机分为米索前列醇组、米非司酮组和正常对照组,每组32例。观察3组患者的手术时间、术中出血量,以及米索前列醇组和米非司酮组药物不良反应。结果米索前列醇组、米非司酮组和对照组相比,手术时间明显缩短,术中出血显著减少,差异均有统计学意义(p<0.05);米索前列醇组与米非司酮组相比,手术时间和术中出血量差异无统计学意义(p>0.05),但米索前列醇组的药物不良反应发生率明显<米非司酮组,差异有统计学意义(p<0.05)。结论术前米索前列醇塞肛给药和短期口服米非司酮均能减少腹腔镜下子宫肌瘤切除术中出血,但米索前列醇药物的不良反应发生率明显降低。

Objective To compare the preoperative misoprostol in per rectum and short-term oral mifepristone on reducing the bleeding in laparoscopic myomectomy. Methods 96 patients with laparoseopic myomeetomy were randomly divided into misoprostol group, mifepristone group and control group, each group involved 32 cases. The operation time, bleeding during the operation, misoprostol and mifepristone group of adverse drug reaction were observed. Results Compared with the control group, operation time and intraoperative bleeding were significantly reduced in others groups （ P 〈 0. 05 ） ; there is no difference a- bout the time of operation and intraoperative bleeding between mifepristone group and misoprostol group （P 〉 0.05 ） , but the side effects of misoprostol group was significantly lower than the mifepristone group （ P 〈 0. 05 ）. Conclusions Preoperative misoprostol in per rectum and the short-term oral mifepristone can reduce the bleeding in laparoscopic myomectomy, but the side effects of misoprostol was significantly less than the mifepristone.