垂体后叶素在良性子宫疾病难度手术中的应用

Effect of pituitrin in difficult operation for patients with benign uterine disease

目的探讨垂体后叶素在良性子宫疾病手术操作困难患者中的应用效果。方法选取96例子宫切除困难的良性子宫疾病患者,随机分为观察组和对照组各48例。观察组在术中应用垂体后叶素,对照组在术中应用0.9%氯化钠液。比较两组的手术时间、术中出血量、术前术后血红蛋白差值及并发症情况,记录观察组在用药前后的血压和心率的变化。结果观察组的手术时间、术中出血量和术前术后血红蛋白差值(118.6±17.8)min,(193.8±48.9)ml,(8.8±3.6)g/L均显著低于局部注射生理盐水的对照组(147.9±19.9)min,(318.2±47.0)ml,(17.5±5.2)g/L,P值均<0.05)。观察组患者用药后5min(117.96±5.46)mmHg,(69.84±4.86)mmHg,(72.91±3.98)次/min、10min(111.86±5.38)mmHg,(65.90±4.31)mmHg,(75.02±3.96)次/min)的SBP、DBP和HR均显著高于用药前(109.35±5.21)mmHg,(64.02±3.62)mmHg,(72.91±3.98)次/min,P值均<0.05)。而观察组患者注射垂体后叶素稀释液后25min的SBP、DBP和HR和用药前无显著差异(110.21±5.32)mmHg,(63.89±4.73)mmHg,(73.43±3.92)次/min,P值均>0.05)。观察组并发症发生率(4.2%)显著低于对照组(27.1%,P<0.05),观察组的盆腔血肿和腹部切口感染的发生率(0,0)低于对照组(8.3%.8.3%,P值均<0.05)。结论对于困难子宫全切除术的良性子宫疾病患者,术中应用垂体后叶素可以明显缩短手术时间,减少术中出血量和并发症,值得临床推广。

Objective To investigate the effect of pituitrin in difficult operation for patients with benign uterine disease. Methods 96 difficult hysterectomy patients with benign uterine disease were randomly divided into the observation group （n=48） and the control group （n=48）. The observation group was given pituitrin during hysterectomy. The control group was given 0.9 % sodium chloride solution during hysterectomy. The operative time, total blood loss during the operation, the change of hemoglobin before and after operation, the incidence of complications were compared between the two groups. The change of blood pressure and heart rate of the observation group were recorded. Results The operative time, total blood loss during the operation and the change of hemoglobin before and after operation of the observation group （118. 6±17. 8）min, （193.8±48.9）ml, （8.8±3.6）g/L were significantly lower than the control group （147.9 ±19.9）min,（318.2±47.0）ml, （17. 5±5.2）g/L, all P〈0. 05）. The SBP,DBP and HR increased 5min and 10min after pituitrin injection in the observation group to （111.86 ±5.38）mmHg, （65.90±4.31）mmHg, （75.02± 3.96）min and （111.86±5.38）mmHg, （65.90±4.31）mmHg, （75.02±3.96）rain,which were all significantly higher than those before pituitrin injection （109.35±5.21）mmHg, （64. 02±3.62）mmHg, （72.91±3.98）rain, all P〈0.05）. The SBP,DBP and HR did not change 25 rain after pituitrin injection in the observation group （ 110.21 ±5.32 ） mmHg, （ 63.89 ±4.73 ） mm- Hg,（73.43±3.92）min,,all P〈0.05）. The incidence of complications in the observation group（4.2%） was significantly lower than the control group（27.1%,P〈0.05）. The incidence of pelvic hematoma and infection of abdominal incision in the observation group（0,0） were significantly lower than the control group（8.3% ,8.3%, all P〈0.05）. Conclusions In difficult hysterectomy for patients with benign uterine disease, pituitary injection during operation could shorten operative time and reduce blood loss and complication.