腹腔镜子宫肌瘤剔除术中减少出血的方法研究

目的：研究减少腹腔镜子宫肌瘤剔除术中出血的方法。方法将2011年2月～2013年10月在我院行子宫肌瘤手术的患者80例随机分成两组，每组40例，对照组常规行腹腔镜子宫肌瘤剔除术，术中局部注射垂体后叶素；实验组术中先于子宫峡部施以压脉带（止血带）并于子宫下段后方打一方结（活结），先减少大部分子宫血供，然后剔除肌瘤，并局部注射垂体后叶素。对两组手术时间、出血量、是否输血及住院治疗时间等进行比较研究。结果实验组手术时间明显缩短，出血量明显减少，无需输血，术后恢复更快。结论在腹腔镜子宫多发肌瘤剔除术中使用压脉带压紧子宫峡部的方法，能使术中出血显著减少，同时最大限度减少对患者术后子宫妊娠及卵巢功能的影响，是一种很好的手术方法，值得临床推广。

Clinical research of reducing blood loss during laparoscopic myomectomy

Objective To research the methods for reducing blood loss during laparoscopic myomectomy. Methods From February 2011 to October 2013, 80 cases with a diagnosis of uterine fibroids underwent laparoscopic myomecto-my. They were randomly divided into two groups of 40 cases, patients in the control group were performed traditionary laparoscopic myomectomy with pituitary vasopressin, while in the experimental group, laparoscopic myomectomy with pituitary vasopressin were performed following isthmus uteri being clamped by tourniquets being tied one knot （slip-knot） at the rear of the lower uterine segment, hysteromyoma was resected after most blood supply was reduced. The data of the two groups including the mean operative time, the blood loss, the blood transfusion, and the hospitalization time were comparatively analyzed. Results Patients in the experimental group were of significantly shorter operative time and less blood loss, none underwent blood transfusion, postoperative recovery was faster. Conclusion The method of the isthmus uteri being clamped by tourniquets during laparoscopic myomectomy for multiple uterine fibroids, can significantly reduce blood loss, simultaneously minimize the impact on the postoperative uterine pregnancy and ovarian function, it is a good surgical method, and worth being popularized.