垂体后叶素液体分离法在腹腔镜下子宫肌壁间肌瘤剔除术中的应用

Application Value of Pituitrin Liquid Chromatography in Laparoscopic Hysteromyomectomy

目的探讨垂体后叶素液体分离法在腹腔镜下子宫肌壁间肌瘤剔除术中的应用价值。方法将2010年2月~2014年12月349例腹腔镜下子宫肌瘤剔除术按掷硬币法分为2组：垂体后叶素液体分离组（n=162）将稀释的垂体后叶素注射于子宫肌瘤的包膜内,游离出部分肌瘤组织后,将腹腔镜用穿刺针插入瘤体与包膜间,形成＂水垫＂,紧贴瘤体包膜一边加压注射稀释垂体后叶素的生理盐水,一边钝性分离出肌瘤;直接剥离组（n=187）均不注射＂水垫＂,直接钝性分离剥除肌瘤。结果液体分离组手术时间明显短于直接剥离组[（56.5±10.2）min vs.（90.5±11.9）min,t=-28.426,P=0.000];术中出血量显著减少[（20.5±5.5）ml vs.（50.5±5.8）ml,t=-49.358,P=0.000],抗生素使用时间明显缩短[（3.3±1.5）d vs.（4.6±2.5）d,t=-5.778,P=0.000]。2组肛门排气时间[（20.9±3.7）h vs.（21.1±3.9）h,t=-0.489,P=0.625]和住院时间[（7.9±1.8）d vs.（8.1±2.0）d,t=-0.976,P=0.330]无统计学差异。结论腹腔镜下子宫肌瘤剔除术中应用垂体后叶素液体分离法可明显缩短手术时间,控制术中出血量,且操作简单,具有良好的临床应用价值。

Objective To explore the application value of pituitrin liquid chromatography in laparoscopic hysteromyomectomy. Methods A total of 349 patients receiving laparoscopic hysteromyomectomy from February 2010 to December2014 were dived into two groups randomly by using the coin toss method. For pituitrin liquid separating group（ n = 162）,the dilution of pituitrin was injected into the uterine fibroid membrane. After the disconnection of part of myoma tissues,a laparoscopic puncture needle was inserted between the tumor and the capsule to make a ＂ water pillow＂. With pressure injection of saline with pituitrin next to the fibroid membrane,the myoma was blunt dissected. For control group（ n = 187）,blunt dissection of the myoma was performed directly without injection of ＂ water-pillow ＂. Results As compared to the control group,the liquid separating group had significantly shortened operation time [（ 56. 5 ± 10. 2） min vs.（ 90. 5 ± 11. 9） min,t =- 28. 426,P = 0. 026 ],significantly less intraoperative bleeding amount [（ 20. 5 ± 5. 5） ml vs.（ 50. 5 ± 5. 8） ml,t =- 49. 358,P = 0. 000],significantly reduced time of antibiotic use [（ 3. 3 ± 1. 5） d vs.（ 4. 6 ± 2. 5） d,t =- 5. 778,P = 0. 000],and significantly shortened anal exhaust time [（ 20. 9 ±3. 7） h vs.（ 21. 1 ± 3. 9） d,t =- 0. 489,P = 0. 025]. There was no significant difference in the length of hospital stay between the two groups[（ 7. 9 ± 1. 8） d vs.（ 8. 1 ± 2. 0） d,t =- 0. 976,P = 0. 330]. Conclusions Application of pituitrin liquid chromatography in laparoscopic hysteromyomectomy offers a high clinical value. It can obviously shorten the operation time and control the intraoperative bleeding.