垂体后叶素或缩宫素在腹腔镜肌壁间子宫肌瘤剔除术中应用的对比研究  

Comparison of Pituitrin and Oxytocin for Hemostasis during Laparoscopic Resection of Intramural Hysteromyoma

作　　者：梅松原[1] 刘艳庚[1] 韩秋丽[1] 孙晓波[1] 崔艳梅[1] 那冠男[1] 

机构地区：[1]中航工业哈尔滨二四二医院妇产科,哈尔滨150066

出　　处：《中国微创外科杂志》2011年第9期801-804,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜肌壁间子宫肌瘤剔除术应用垂体后叶素及缩宫素止血的优缺点。方法 2008年1月-2009年6月对68例肌壁间子宫肌瘤施行腹腔镜子宫肌瘤剔除术;32例为垂体后叶素组,切开浆膜层前子宫肌层注射垂体后叶素6 IU＋0.9%氯化钠注射液10 ml;36例为缩宫素组,注射缩宫素20 IU＋0.9%氯化钠注射液10 ml。比较2组手术时间、术中出血量、术后血红蛋白及用药前后血压的变化。结果 2组手术均顺利完成,无中转开腹。垂体后叶素组及缩宫素组相比,手术时间明显减少[（69.8±18.0）min vs.（82.8±17.6）min,t=-3.008,P=0.004],术中出血量明显减少[（68.5±19.6）ml vs.（88.5±25.6）ml,t=-3.583,P=0.000],术后血红蛋白下降幅度小[（11.0±2.6）g/L vs.（12.5±2.9）g/L,t=-2.234,P=0.029]。术中用药后15 min,垂体后叶素组收缩压上升,显著高于缩宫素组[（152.0±8.5）mm Hg vs.（146.5±10.2）mm Hg,t=2.398,P=0.019],用药30 min和45 min后,垂体后叶素组与缩宫素组收缩压无显著性差异（P〉0.05）。结论腹腔镜肌壁间子宫肌瘤切除术中使用垂体后叶素止血效果优于缩宫素,可明显减少术中出血,减少手术时间,值得推广应用。Objective To compare the hemostasis effect of pituitrin and oxytocin in laparoscopic surgery for intramural hysteromyoma.Methods Clinical data of 68 cases with intramural hysteromyoma who underwent laparoscopic resection from January 2008 to June 2009,were enrolled into this study（32 cases in pituitrin group,36 cases in oxytocin group）.Before open placenta incision,the cases in pituitrin group were injected with pituitrin 6 IU ＋ normal saline 10 ml and oxytocin group recieved 20 IU oxytocin＋normal saline 10 ml.The blood pressure,operation time,blood loss during the operation and the postoperative change of hemoglobin were analyzed.Results All the operations were successfully completed without converting to transabdominal operation.The operation time of the pituitrin group were significantly shorter than that in the oxytocin group [（69.8±18.0） min vs.（82.8±17.6） min,t=-3.008,P=0.004].The blood loss of the pituitrin group were significantly less than that of oxytocin group [（68.5±19.6） ml vs.（88.5±25.6） ml,t=-3.583,P=0.000].The decrease of hemoglobin after operation in pituitrin roup were smaller than that of oxytocin group [（11.0±2.6） g/L vs.（12.5±2.9） g/L,t=-2.234,P=0.029].The blood pressure increased 15 min after pituitrin injection in the pituitrin group to（152.0±8.5） mm Hg,which was significantly higher than that of oxytocin group [（146.5±10.2） mm Hg,t=2.398,P=0.017].No significant differences in blood pressure increase in 30 and 45 min after injection were observed between the two groups（P0.05）.Conclusions The effect of hemostasis with pituitrin in laparoscopy for intramural hysteromyoma is better than oxytocin.Injection of pituitrin can decrease intraoperative blood loss and shorten operation time.

关 键 词：腹腔镜 子宫肌瘤剔除术 垂体后叶素 缩宫素 

分 类 号：R737.33[医药卫生—肿瘤]