腹腔镜下卵巢子宫内膜异位囊肿剔除术注射垂体后叶素或卡前列素氨丁三醇的效果分析

The Effectiveness Analysis of Injecting Carboprost Tromethamine or Hypophysin in the Ovarian Endometriosis Cyst Removal Surgery Under Laparoscope

目的探讨在腹腔镜下卵巢子宫内膜异位囊肿剔除术中子宫肌层注射垂体后叶素和卡前列素氨丁三醇(欣母沛)的安全性和可行性。方法对厚街医院腹腔镜下卵巢子宫内膜异位囊肿剥除术76例患者,分为注射欣母沛组(A组)31例,注射垂体后叶素组(B组)29例,未使用药物对照组(C组)16例,比较三组的手术时间、术中出血量、术后并发症、术后第一天体温、血红蛋白及血压变化等指标。结果 A组的手术时间平均为(107.74±13.28)min,术中出血量平均为(114.67±28.10)mL。B组的手术时间平均为(108.28±10.71)min,术中出血量平均为(110.68±21.66)mL。对照组C组的手术时间平均为(132.81±11.25)min,术中出血量平均为(169.38±34.54)mL。差异有统计学意义(P<0.05)。术前术后血红蛋白的变化,A、B两组变化较小,差异有统计学意义(P<0.05)。三组术后第一天最高体温、肛门排气时间及住院天数,差异无统计学意义(P>0.05)。A组的少数患者出现术中用药后血压一过性升高,B组也有少数患者出现血压一过性升高,相对A组的升高不明显。结论腹腔镜下卵巢子宫内膜异位囊肿剔除术中使用垂体后叶素和欣母沛辅助手术,均能减少术中出血量,缩短手术时间,有效避免术后的并发症,是安全有效、可行的术中用药方法。

Objective This study aims to investigate the feasibility and safety of ovarian endometriosis cyst removal surgery injecting carboprost tromethamine（ hemabate） or hypophysin into myometrium in laparoscopy. Methods A total of 76 patients with laparoscopic ovarian endometriosis cyst stripping were enrolled into the study in Houjie. They were freely classified into three groups,including 31 patients injected hemabate（ A group）,29 patients injected hypophysin（B group） and 16 patients never using hemabate or hypophysin（C group）. The operative time,intraoperative blood loss,blood pressure,postoperative change of hemoglobin,surgical complications and postoperative highest body temperature in the first day of the three groups were compared. Results The average operative time of A group was（107. 74 ±13. 28） min,and the average blood loss during the operation was（114. 67 ± 28. 10） mL. The average operative time of B group was（108. 28 ± 10. 71） min,and the average blood loss during the operation was（110. 68 ± 21. 66） mL. The average operative time of control（ C） group was（132. 81 ± 11. 25） min,and the average blood loss during the operation was（169. 38 ± 34. 54）mL. the difference was statistically significant（P〈0. 05）. The variation degree of hemoglobin in the postoperation from A and B groups were significantly less than that in C group（ P〈0. 05）. No significant differences existed surgical complications,postoperative highest body temperature in the first day,postoperative exhaust time and postoperative hospitalization time in the three groups（ P〉0. 05）. Few patients of A group had a transient high blood pressure after drugging,but we found no obvious difference between A and B group. Conclusions Using hemabate or hypophysin of ovarian endometriosis cyst surgery in laparoscopy assisted surgery can reduce intraoperative bleeding and shorten operation time,and effectively avoid postoperative complications. It is a safe,effective and feasible method for intraoperative medication in laparoscopy.