小剂量垂体后叶素联合缩宫素在腹腔镜子宫肌壁间肌瘤剔除术中的止血效果观察

Hemostatic effect of low dose pituitrin combined with oxytocin in laparoscopic intramural myomectomy

目的观察垂体后叶素联合缩宫素在腹腔镜子宫肌壁间肌瘤剔除术的止血效果,对止血的优缺点进行分析。方法随机选取北京妇产医院2012年5月至2017年5月行腹腔镜子宫肌壁间肌瘤剔除术患者820例,按处理方法不同分为试验组(400例)和对照组(420例)。试验组予垂体后叶素(3 U)联合缩宫素(20 U),对照组予缩宫素(20 U),比较2组手术时间、出血量和术后血红蛋白下降情况,并观察2组血压变化。结果全部手术均在腹腔镜下顺利完成。试验组手术时间与对照组相比明显缩短([65.8±12.2)min vs.(79.2±15.0)min,P<0.05],试验组出血量与对照组相比明显减少([52.9±6.9)ml vs.(78.0±7.2)ml,P<0.05],试验组术后血红蛋白下降水平与对照组相比显著降低([0.9±0.1)g/L vs.(1.2±0.2)g/L,P<0.05]。结论小剂量垂体后叶素联合缩宫素在腹腔镜子宫肌壁间肌瘤剔除术的止血效果明显优于单用缩宫素,手术时间短、出血少,且提供了更稳定的血流动力学,值得在临床推广应用。

Objective To investigate the hemostatic effect of pituitrin combined w-ith oxytocin in laparoscopic in- tramural myomectomy, and to analyze the advantages and disadvantages of hemostasis. Methods Eight hundred and twenty cases who were underwent laparoscopic intramural myomectomy were randomly selected from May 2012 to May 2017. According to different treatment methods, they were divided into the experimental group （400 cases） and the control group （420 cases）. The experimental group was given pituitrin （3 U） combined with oxytocin （20 U）, and the control group was given oxytocin （20 U）only. The time of operation, the amount of bleeding and the decreased level of hemoglo- bin in the two groups were compared. The changes of blood pressure were observed at the same time. Results All the op- erations were performed successfully under laparoscope. The operation time of experimental group was significantly de- creased [（65.8± 12.2）min vs. （79.2±15.0）min, P 〈 0.05], the amount of bleeding was significantly reduced [（52.9±6.9）ml vs. （78.0±7.2）ml, P 〈 0.05], and the level of hemoglobin [（0.9±0.1）g/L vs. （1.2±0.2）g/L, P 〈 0.05）] was less decreased compared with control group. Conclusion The hemostatic effect of low dose pituitrin combined with oxytocin is signifi- cantly better than oxytocin alone in laparoscopic intramural myomectomy. The combination can not only shorten the opera- tion time, but also reduce the amount of bleeding and provide a more stable hemodynamics. It is worthy of clinical applica- tion.