垂体后叶素对子宫肌瘤病人腹腔镜术中眼内压影响

EFFECT OF PITUITRIN ON INTRAOCULAR PRESSURE DURING LAPAROSCOPIC HYSTEROMYOMECTOMY

目的了解腹腔镜妇科手术术中使用垂体后叶素对病人眼内压（IOP）的影响。方法选择全麻下行腹腔镜子宫肌瘤切除病人40例,ASA分级Ⅰ级或Ⅱ级,随机分为垂体后叶素组（观察组）和生理盐水对照组（对照组）,各20例。建立气腹后,观察组经由子宫肌层注射垂体后叶素6U,对照组局部注射生理盐水。比较两组诱导前（T0）、注药前（T1）及注药后2min（T2）、15min（T3）、30 min（T4）的平均动脉压（MAP）、心率（HR）及IOP的差异。结果观察组T2、T3、T4时点与T0、T1时点比较,MAP均明显升高,HR明显减慢,差异有显著意义（F=105.2、24.3,P〈0.05）;与对照组比较差异也有显著性（t=10.331-11.274,P〈0.05）。对照组各时点MAP、HR比较差异无显著性（P〉0.05）。与T0比较,两组T1、T2、T3、T5时点IOP均明显升高,差异有显著意义（F=605.9、527.5,P〈0.05）;但两组间各时点比较差异无统计学意义（P〉0.05）。结论腹腔镜子宫肌瘤切除术中使用垂体后叶素对IOP无明显影响。

Objective To investigate the effect of pituitrin on intraocular pressure （IOP） during laparoscopic hystero myomectomy （HMM）. Methods Forty patients undergoing laparoscopie HMM under general anesthesia were selected, ASA Ⅰ or Ⅱ , and evenly randomized to two groups as pituitrin group （observation group） and normal saline group （control group）. After establishing pneumoperitoneum, 6 U of pituitrin was injected into myometrium of the observation group, and of the control group, normal saline was locally injected. The differences in mean arterial pressure （MP）, heart rate （HR） and IOP --before induction （To）, before the injection of drugs （T1）, 2 min （T2）, 15 min （T3）, and 30 ,in （T4） after drug injection--were compared be- tween the two groups. Results In the observation group, MAP at T2, T3 and T4 were much higher than that at T0, T1, and HR obviously slowed down （F = 105.2,24.3;P 〈0.05）. The differences in MAP and HR among each time point in the control group were not significant （P〉0.05）. Compared with To, IOP at T1, T2, T3 and T4 time points in both groups elevated （F= 605.9,527.5;P〈0.05）, but the differences in that among each time points were not significant （P〉0.05）. Conclusion Using pituitrin at laparoscopic hysteromyomeetomy does not affect intraocular pressure.