垂体后叶素与缩宫素在开腹子宫肌瘤切除术中的效果研究(1)
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【摘要】目的:比较开腹子宫肌瘤切除术患者术中应用垂体后叶素或缩宫素后的有效性和安全性。方法:130例开腹子宫肌瘤切除术患者随机分为2组，垂体后叶素组和缩宫素组，每组65例。比较2组患者既往病史等一般资料、平均出血量、手术时间、不良反应等情况。结果:与缩宫素组患者比较，垂体后叶素组患者的术中出血明显减少，该组的手术时间明显缩短，但不良反应较严重。结论:垂体后叶素可以明显减少开腹子宫肌瘤切除术患者的术中出血，但发生心血管系统不良反应的几率较高，程度较重。
【关键词】垂体后叶素；缩宫素；开腹子宫肌瘤切除术；窦性心律过缓
Comparison between effects of pituitrin and oxytocin in patientsundergoing laparotomic hysteromyomectomy
Gong Yuzhu1 Zhang Limin2
【Abstract】 Purpose: To investigate the effects and safety of pituitrin and oxytocin in patients undergoing laparotomic hysteromyomectomy. Methods: 130 patients undergoing laparotomic hysteromyomectomy were randomly divided into 2 groups (n65), patients receiving pituitrin or oxytocin. Thereafter, comparison in general characteristics of patients such as past medical history, measurement of bleeding volume, time of the surgery lasted as well as adverse reaction was made between pituitrin group and oxytocin group. Results: Comparing to that of patients in oxytocin group, bleeding volume during the surgery of patients in pituitrin group were dramatically reduced, furthermore, the time of surgery lasted was obviously shortened; whereas, the adverse reaction in pituitrin group was more severe than that in oxytocin group. Conclusion: Pituitrin could reduce the bleeding volume of patients undergoing laparotomic hysteromyomectomy, however, the probability of adverse reaction in cardiovascular system in patients receiving pituitrin was much higher than that of people receiving oxytocin, and the extent of adverse reaction in pituitrin group was much more severe in comparison with that of oxytocin group.
【Key words】 Pituitrin; Oxytocin; Laparotomic hysteromyomectomy; Brady sinus rhythm
【中图分类号】R713.4【文献标识码】B【文章编号】1008-6455(2011)08-0104-02
垂体后叶素对平滑肌有强烈的收缩作用，尤以对血管及子宫肌层的作用更强[1]，近年来被广泛应用于子宫肌瘤切除术，以达到术中减少出血的目的。2008年12月～2010年12月，本院手术室共实行开腹子宫肌瘤切除术130例，随机分为垂体后叶素组和缩宫素组，对两种药物在术中的止血作用、对心血管系统的影响及愈后情况进行对比。
1 资料
130例子宫肌瘤患者均已婚，年龄25～45岁，平均年龄33.2岁。术前检查排除有高血压、冠心病、哮喘、慢性心功能不全等疾病。其中，子宫肌瘤单发性75例，多发性55例；肌壁间51例，浆膜下37例，混合型42例；肌瘤数目1～5个；浆膜下最大直径9.7cm，肌壁间最大直径6.7cm。将患者随机分为垂体后叶素组和缩宫素组，每组65例。其中术前垂体后叶素组糖尿病者3例，甲状腺功能亢进者2例，低血压患者3例，抑郁症者1例；缩宫素组糖尿病者4例，甲状腺功能亢进者1例，低血压患者4例；两组术前经常规治疗达标后再行手术。其余患者均身体健康，术前未服用药物。两组病例在年龄、既往病史、术前用药等比较无统计学意义(P>0.05)，具有可比性。
2 方法
2.1 麻醉方法： 两组均采用腰硬联合麻醉，麻醉药为0.5%布比卡因葡萄糖液2.5～3ml，麻醉前30min规肌注阿托品0.5mg，苯巴比妥钠0.1g。入手术室后左侧桡动脉穿刺用于监测动脉压 ......
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