腹腔镜下子宫肌瘤剔除术减少术中出血的两种方法比较

目的探讨腹腔镜下子宫肌瘤剔除术中减少术中出血的方法。方法 2007年1月～2009年12月,我院行腹腔镜下子宫肌瘤剔除112例,其中予垂体后叶素子宫壁肌注后直接剔除(A组)58例,垂体后叶素宫壁肌注后联合PK刀对瘤蒂进行处理(B组)54例。结果所有病例均在镜下完成,无一例中转开腹。2组术后肛门恢复排气时间、术后住院时间、术后并发症发生率差异均无显著性(P0.05)。术中出血量A组(55.0±14.8)ml,B组(28.8±11.9)ml);术后血红蛋白较术前下降A组(7.1±1.2)g/L,B组(5.8±2.2)g/L,差异均有统计学意义(P0.05)。结论在腹腔镜子宫肌瘤剔除术中,垂体后叶素宫壁肌注联合PK刀对肌瘤假包膜的处理可减少术中出血,值得推广应用。

Comparison of Two Methods for Reducing Blood Loss during Laparoscopic Myomectomy

Objective To investigate the methods for hemorrhage controlling in the laparoscopic myomectomy.MethodsA retrospective analysis was carried out on 112 cases of laparoscopic myomectomy that were performed during January 2007 to December 2009.The patients who received intramuscular injection of pituitrin into the uterine wall was assigned to group A（58 cases）,and those who were treated with PlasmaKinetic System after intramuscular injection of pituitrin was set as group B（54 cases）.Results All the operations were completed successfully without conversion to laparotomy.No significant difference was found in the recovery time of gastrointestinal function,postoperative hospital stay,and postoperative morbidity（P0.05）.Whereas,group A showed significantly more blood loss （55.0±14.8）ml vs（28.8±11.9）ml,P0.05] and higher decrease of Hb level after the operation （7.1±1.2）g/L vs（5.8±2.2）g/L,P0.05].Conclusion Intramuscular injection of pituitrin combined with PlasmaKinetic System can reduce blood loss during laparoscopic myomectomy.