腹腔镜下子宫肌瘤剔除术应用垂体后叶素的效果  

Effect of pituitrin in myomectomy under laparoscopy

作　　者：王安杰[1] 杨瑞英[1] 

机构地区：[1]河北省邢台市人民医院,054001

出　　处：《中国妇幼保健》2015年第5期798-800,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨腹腔镜下子宫肌瘤剔除术中应用垂体后叶素联合缩宫素、单用缩宫素及子宫动脉阻断止血的效果。方法:回顾分析30例腹腔镜下大子宫肌瘤剔除术患者的临床资料,将30例患者随机分为3组,每组10例,垂体后叶素联合缩宫素止血组于切开浆膜层前子宫肌层注射垂体后叶素6 IU及注射缩宫素10 U;缩宫素止血组予注射缩宫素20 U;子宫动脉阻断止血组在双侧子宫动脉上行支阻断后行肌瘤切除术,比较3组手术时间、术中出血量及术后血肿形成情况。结果:垂体后叶素联合缩宫素止血组平均手术时间为(83.7±29.5)min,与子宫动脉阻断止血组相近,缩宫素止血组平均手术时间为(115.3±62.5)min,明显长于前两组(P<0.05);子宫动脉阻断止血组、垂体后叶素联合缩宫素止血组术中出血量分别为(70.2±34.6)ml、(78.5±35.2)ml,明显少于缩宫素止血组(P<0.05);子宫动脉阻断止血组及垂体后叶素联合缩宫素止血组术后均无血肿形成,缩宫素止血组有1例血肿形成。结论:垂体后叶素联合缩宫素止血及子宫动脉阻断术止血的效果均优于缩宫素止血,是有效的止血方法。垂体后叶素联合缩宫素止血操作易于掌握,而子宫动脉阻断术则相对复杂,要求术者必须具有熟练的腹腔镜操作技术。Objective： To explore the hemostatic effects of pituitrin combined with oxytocin, oxytocin and uterine artery occlusion in myomectomy under laparoscopy. Methods： The clinical data of patients receiving myomectomy under laparoscopy were analyzed retrospectively, 30 patients were randomly divided into three groups, 10 patients in each group, the patients in pituitrin combined with oxytocin group were treated with myometrial injection of pituitrin （6 IU） and oxytocin （10 U） before cutting perimetrium, the patients in oxytocin group were treated with injection of oxytocin （20 U） , the patients in uterine artery occlusion group were treated with bilateral ascending uterine artery block before myomectomy. The operation time, the amount of intraoperative blood loss and postoperative hematoma formation in the three groups were compared. Results ： The average operation time in pituitrin combined with oxytocin group was （ 83.7 ± 29. 5 ） minutes, which was similar to uterine artery occlusion group, the average operation time in oxytocin group was （115.3 ± 62. 5 ） minutes, which was statistically significantly longer than those in the other two groups （ P 〈 0. 05 ） ; the amount of intraoperative blood loss in uterine artery occlu- sion group and pituitrin combined with oxytocin group were （70. 2 ± 34. 6） ml and （78.5 ± 35.2） ml, respectively, which were statistically significantly lower than that in oxytocin group （ P 〈 0.05 ） ; in uterine artery occlusion group and pituitrin combined with oxytocin group, no postoperative hematoma formation was found, while in oxytocin group, one patient was found with postoperative hematoma. Conclusion： The hemostatic effects of pituitrin combined with oxytocin and uterine artery occlusion are superior to oxytocin, which are effective hemostatic methods. Pituitrin combined with oxytocin for hemostasis is easy to operate, while uterine artery occlusion is relatively complicated, which re- quires surgeons have skilled laparoscopic operation

关 键 词：腹腔镜 大子宫肌瘤 垂体后叶素 止血效果 

分 类 号：R713.4[医药卫生—妇产科学]