垂体后叶素在腹腔镜下大子宫次全切除术中的应用

目的 观察垂体后叶素在腹腔镜下大子宫次全切除术中的应用效果.方法 选取2013年1月至2014年11月在我院妇科行腹腔镜下大子宫次全切除术治疗的患者102例,根据患者是否使用垂体后叶素分为观察组(n=70)和对照组(n=32),观察组患者给予垂体后叶素子宫体肌层注射治疗,并根据给药剂量分为A组(n=34,垂体后叶素6U)和B组(n=36,垂体后叶素12 U),对照组患者术中未应用垂体后叶素.比较三组患者术中及术后情况,并分别于给药前、给药后1 min、3 min、5 min、10 min、30 min监测患者氧分压(SpO2)、心率(HR)、血压(BP)的变化和并发症发生情况.结果 观察组与对照组患者在手术时间、术中出血量、术后血红蛋白(Hb)下降水平和并发症发生率方面比较差异均具有统计学意义(P<0.05),但A组和B组间的上述各指标间比较差异均无统计学意义(P>0.05);垂体后叶素给药前后,观察组患者SpO2均无明显变化(P>0.05),A组和B组患者HR均降低,A组患者的HR在给药后5 min、10 min、30 min明显低于给药前(P<0.05),B组患者的HR在给药后3 min、5 min、10 min、30 min明显低于给药前(P<0.05),且下降幅度明显大于A组(P<0.05);与给药前比较,A组和B组患者收缩压(SBP)和舒张压(DBP)在给药后1 min、3 min、5 min、10 min、30 min时均明显升高(P<0.05),且B组患者升高幅度明显大于A组(P<0.05).结论 腹腔镜下大子宫次全切除术中应用垂体后叶素可明显缩短手术时间,减少术中出血量.小剂量垂体后叶素对机体循环系统影响较少,可广泛应用于临床.

Application of pituitrin in laparoscopic subtotal hysterectomy

Objective To observe the effect of pituitrin in laparoscopic subtotal hysterectomy. Methods A to-tal of 102 patients undergoing laparoscopic subtotal hysterectomy in our hospital from Jan. 2013 to Nov. 2014 were se-lected and divided into observation group (n=70) and control group (n=32) according to whether use pituitrin or not. Pa-tients of the observation group were given muscular injection of pituitrin in uterus, which were divided into group A (n=34, at the dose of 6 U) and group B (n=36, 12 U) according to the dose of pituitrin. Pituitrin was not applied in the control group. Intraoperative and postoperative conditions were compared between the three groups, and oxygen partial pressure (SpO2), heart rate (HR), blood pressure (BP) changes and complications were observed before administration and 1 min, 3 min, 5 min, 10 min, 30 min after administration. Results The operative time, blood loss, postoperative hemoglobin (Hb) levels decreased, postoperative morbidity of complication showed statistically significant differences between the observation group and control group (P<0.05), but the indexes had no statistically significant differences between group A and group B (P>0.05). Before and after administration of pituitrin, the observation group had no significant changes of SpO2 (P>0.05). HR in group A and group B were significantly decreased. Compared with before administration, HR 5 min, 10 min, 30 min after administration in group A were significantly lower (P<0.05), and HR 3 min, 5 min, 10 min, 30 min after administration in group B were significantly lower (P<0.05), with decrease amplitude in group B significantly great-er than that in group A (P<0.05). Compared with before administration, systolic BP (SBP) and diastolic BP (DBP) 1 min, 3 min, 5 min, 10 min, 30 min after administration in group A and group B were significantly increased (P<0.05), and the increase amplitude in group B were significantly higher than that in group A (P<0.05). Conclusion In laparoscopic sub-total hysterectomy, the application of pituitrin can significantly shorten the operation time, reduce the blood loss. Low-dose pituitrin has less effect on circulatory system, which can be widely used in clinical practice.