欣母沛等三种药物减少腹腔镜下肌壁间子宫肌瘤剔除术中出血的研究

A CONTRAST STUDY ON REDUCING BLEEDING EFFECT OF HEMABATE AND OTHER TWO DRUGS DURING LAPAROSCOPIC RESECTION OF INTRAMURAL HYSTEROMYOMA

目的对比研究腹腔镜下肌壁间子宫肌瘤剔除术应用欣母沛（卡前列素氨丁三醇）、垂体后叶素和缩宫素促子宫收缩减少术中子宫出血的优缺点。方法2009年1月～2012年5月行腹腔镜下肌壁间子宫肌瘤剔除术97例，分成3组，欣母沛组（A组）31例，垂体后叶素组（B组）34例，缩宫素组（C组）32例。比较三组之间的手术时间、术中出血量、术后恢复时间和血压的变化。结果3组手术均顺利完成，无中转开腹。c组手术时间较长和术中出血量较多，与A、B组比较，差异有统计学意义（P〈0．05），A、B组差异无统计学意义（P〉0．05）。用药15min后术中血压B组升高明显，A组轻微升高，C组无明显变化，3组比较差异有统计学意义（p〈0．05）。用药30min后3组血压比较变化不明显，差异无统计学意义（P〉0．05）。结论3组药物应用后均可减少术中出血量，缩短手术时间，且术中应用均较安全，副反应较轻，欣母沛和垂体后叶素应用效果要明显好于缩宫素，但欣母沛价格较高，术者可根据患者实际情况综合考虑，灵活应用。

Objective To compare the hemostasis effects of hemabate, pituitrin and oxytocin in laparoscopic surgery for intramural hysteromyoma. Method 97 cases of patients with intramural hysteromyoma from January 2009 to May 2012 were divided into three groups, 31 cases in group hemabate （A group）, 34 cases in group pituitrin （B group） and 32 cases in group oxytocin （C group）. The operation time, the blood loss during the operation, the rehabilitation time postoperative and change of the blood pressure after using medicine were analyzed. Result All the operations were successfully completed without converting to transabdominal operation. The operation time and the blood loss during the operation of group C were more than group A and group B, the difference was statistically signifi- cant （p 〈0.05）, the differences of group A and group B had no significance statistically （p 〉 O. 05 ）. The blood pressure increased 15 min after group B injection were higher than the other two groups, the group A increased little and no change after group C injection, the difference was statistically significant （p 〈 0.05 ）. No significant differ- ences in blood pressure increase in 30 min after injection were observed in the three groups （p 〉 0.05）. Conclusion The three groups medicine used can effectively reduce the blood loss, short the surgery time as well. Moreover, the using during the operation was safe, and subsidiary reactions were few. The effect of hemabate and pituitrin are better than oxytocin. But the hemabate is expensive. Surgeons can consider the actual situation of patients with comprehensive consideration, flexible application.