两种药物在腹腔镜子宫肌瘤剔除术中止血效果的对比研究

目的研究垂体后叶素和缩宫素在腹腔镜子宫肌瘤剔除术中的止血效果。方法选择2010年1月至2012年12月在平南县人民医院妇科住院行腹腔镜子宫肌瘤剔除术的78例子宫肌瘤患者作为研究对象,按患者入院单双日期分为垂体后叶素组及缩宫素组,垂体后叶素组在肌瘤剔除前宫肌注射垂体后叶素,缩宫素组则注射缩宫素,观察两组患者的手术时间、术中出血量、术后肌门排气时间、术后体温恢复情况、术前与术后3 d血红蛋白差值,以及注药前与注药后15 min、30 min、45 min患者血压和心率及血氧饱和度的变化情况。结果垂体后叶素组患者的手术时间及术中出血量显著少于缩宫素组(t=3.7576、3.6350,P<0.05),血红蛋白差值显著低于缩宫素组(t=3.7570,P<0.05),而术后肛门排气及体温恢复情况与缩宫素组比较,差异无统计学意义(P>0.05)。两组患者使用药物后,收缩压在不同时点间、组间及组间·不同时点间比较,差异均有统计学意义(P<0.05);舒张压及心率在不同时点间、组间及组间·不同时点间的比较,差异均无统计学意义(P>0.05),血氧饱和度的组间比较,有统计学意义(P<0.05),在不同时点间及组间·时点间比较,差异均无统计学意义(P>0.05)。结论垂体后叶素在腹腔镜下子宫肌瘤剔除术中的止血效果优于缩宫素,其能显著缩短手术时间、减小术后血红蛋白下降幅度,值得临床推广应用。

Comparative Study on the Effect of Two Kinds of Hemostatic on Hysteromyomectomy with Peritoneoscope

Objective To study the hemostatic effect of pituitrin and oxytocin on hysteromyomectomy with peritoneoscope.Method A total of 78 patients underwent hysteromyomectomy with peritoneoscope in Pingnan People＇s Hospital from Jan.2010 to Dec.2012 were selected as the study objects and divided into pituitrin group and oxytocin group according to odd and even date.Before hysteromyomectomy,patients in the pituitrin group and oxytocin group were injected with pituitrin and oxytocin respectively.The operation duration,intraoperative blood loss,postoperative anus exhaust time,postoperative body temperature restoration,difference value of hemoglobin before operation and 3 d after operation,and the change of blood pressure,heart rate and oxyhemoglobin saturation before injection and 15 min,30 min and 45 min after injection were compared.Result The operation duration and intraoperative blood loss of pituitrin group were significantly less than those of oxytocin group（t =3.7576,3.6350,P ＜ 0.05）,difference value of hemoglobin was significantly less than that of oxytocin group（t =3.7570,P ＜ 0.05）.In terms of the postoperative anus exhaust time and body temperature restoration,the difference between the two groups was not statistically significant （P ＞ 0.05）.After injection of the medicine,the systolic pressure of the two groups at different time points,different groups and groups time had statistically significant difference （P ＜ 0.05） ; the diastolic pressure,heart rate at different time points,different groups and groups time had no statistically significant difference （P ＞ 0.05） ; the oxyhemoglobin saturation at different groups had statistically significant difference（P ＜0.05）,although there was no statistically significant difference at different time points,and groups time（P ＞0.05）.Conclusion The hemostatic effect of pituitrin is better than that of oxytocin on myomectomy.Pituitrin can significantly shorten the operation time and reduce the decline range of hemoglobin after operati