垂体后叶素在腹腔镜下子宫肌瘤剔除术中的应用

摘要

Objective:To evaluate the efficiency and safety of different doses pituitrin in patients undergoing laparoscopic hysteromyomectomy. Methods:Using the method of random number table,ninety patients who scheduled for elective laparoscop-ic myomectomy under general anesthesia,were divided into three groups(n = 30 each):control group(group C)and different doses pituitrin groups(group P1 and group P2). Group P1 was given myometrium injection with pituitrin 6 U,group P2 was giv-en myometrium injection with pituitrin 12 U,and group C was given oxytocin 20 U. To observe the operation situation,intraop-erative complications and postoperative recovery of three groups,and then compare the clinical efficacy of three groups. Re-sults:The operation time of group P1 and P2 was significantly shorter as compared with the group C,the intraoperative blood losswas less than that of the group C( P ﹤ 0 . 0 5 ). The incidences of cardiovascular responses were 6 . 6 7 % ,4 6 . 6 7 % and 96. 67% in group C,P1 and P2 respectively. The incidence of cardiovascular responses in group P1 and group P2 was signifi-cantly higher as compared with group C(P ﹤ 0. 01,correction αˊ= 0. 0167). The incidence of cardiovascular responses was sig-nificantly higher in groups P2 than in group P1(P ﹤ 0. 01). There were no serious complications in three groups postoperative. Conclusion:Small dosage pituitrin can effectively reduce the intraoperative blood loss and shorten the operation time with few complications in patients undergoing laparoscopic hysteromyomectomy.%目的：评价不同剂量垂体后叶素在腹腔镜下子宫肌瘤剔除术中的止血作用和安全性。方法：选择择期行腹腔镜子宫肌瘤剔除术患者90例，采用随机数字表法将其分为三组（每组30例），对照组（C 组）：子宫肌瘤周围肌层注射缩宫素20 U；P1组：垂体后叶素6 U 子宫肌层注射；P2组：垂体后叶素12 U 子宫肌层注射。观察三组患者的手术情况、术中并发症及术后恢复情况，比较三组的临床疗效。结果：与 C 组相比，P1和 P2组手术时间明显缩短，术中出血量明显减少，差异有统计学意义（P ﹤0.05）。C 组、P1和 P2组术中心血管反应发生率分别为6.67％，46.67％和96.67％。与 C 组比较，P1组、P2组心血管反应发生率明显增高，差异有统计学意义（P ﹤0.01，校正后αˊ=0.0167），与 P1组比较，P2组心血管反应发生率明显升高，差异有统计学意义（P ﹤0.01）。三组术后均未见严重并发症。结论：腹腔镜子宫肌瘤剔除术患者，子宫肌瘤周围肌层注射小剂量垂体后叶素，可减少术中出血量，缩短手术时间，并发症少。