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疗效比较

目的：对比分析采用垂体后叶素与缩宫素止血在腹腔镜子宫肌瘤剔除术中临床疗效。方法将68例肌壁间子宫肌瘤患者按照手术止血方法不同分为垂体后叶素止血组（ A组32例）与缩宫素止血组（ B组36例）,观察对比两组患者手术治疗后的时间、术中出血量、术后血红蛋白水平以及治疗前后血压的变化情况。结果 A组患者手术时间为（69．8±18．0）min,术中出血量为（68．3±19．1）mL,术后排气时间为（15．2±7．8） h,手术前后血红蛋白差值（10．4±2．6） g／L,均显著优于 B 组的（82．8±17．6） min、（88．5±25．6）mL、（19．4±5．9）h、（13．5±2．9）g／L（均P＜0．05）。而A组患者术后病率为5例,B组患者术后病率为9例。两组比较差异无统计学意义（P＞0．05）。 A 组患者用药15 min 后收缩压为（152．0±8．5）mmHg,显著高于B组的（132．5±10．2）mmHg（P＜0．05）。而30 min与45 min后收缩压比较,以及用药前后的舒张压比较,两组差异均无统计学意义（均P＞0．05）。结论临床上进行腹腔镜手术治疗子宫肌瘤疾病过程中,采用垂体后叶素对患者进行止血,能有效减少手术治疗时间、降低手术出血量,手术止血效果整体优于缩宫素,临床效果显著,值得临床上进一步推广应用。

Comparison of the hemostatic efficacy of pituitrin and oxytocin applying in muscle intramural laparoscopic u-terine myomectomy

Objective To compare and analyze the clinical curative effect of pituitrin and oxytocin applying＆nbsp;in laparoscopic uterine myomectomy intraoperation .Methods According to surgical hemostasis method ,68 patients with uterine fibroids were divided into pituitrin group （group A） and oxytocin group（group B）.The surgery time,intr-aoperative blood loss ,the change of postoperative hemoglobin levels and the change of blood pressure before and after treatment were observed.Results In A group,the operative time was （69.8 ±18.0）min,blood loss was （68.3 ± 19.1）mL,postoperative discharge time was （15.2 ±7.8）h,preoperative and postoperative hemoglobin difference val-ue was （10.4 ±2.6） g/L,which were significantly better than those in group B [（82.8 ±17.6） min,（88.5 ± 25.6）mL,（19.4 ±5.9）h,（13.5 ±2.9）g/L],the differences were statistically significant （all P0.05）.In A group,the systolic blood pressure was （152.0 ±8.5）mmHg after treatment for 15min,which was significantly higher than （132.5 ±10.2）mmHg in group B,the difference was statistically significant （P0.05）.Conclusion Application of pituitrin in laparoscopic surgical hemostasis for patients with uterine fibroids can effectively reduce the surgery time ,decrease the blood loss ,its surgical hemostasis effect is better than oxytocin ,which is worth further clinical application .