Study on hemostatic effect of different methods of oxytocin in laparoscopic myomectomy / 中国综合临床

ABSTRACT

Objective To examine the hemostatic effect of oxytocin in laparoscopic myomectomy,and to clarify the optimal dosage of oxytocin in laparoscopic myomectomy. Methods From January 2016 to July 2017, ninety patients with myoma of uterus who underwent laparoscopic myomectomy in Tangshan Union Medical College Hospital were divided into two groups group A and group B,45 cases in each group. In group A,the patients were given 20U oxytocin and 5％ glucose injection 250 ml via intravenous drip, and in group B, the patients were injected with 20U oxytocin on the muscular wall of uterus myoma during operation. The preoperative, postoperative basic situation, intraoperative blood loss, operation time, intraoperative and postoperative adverse reactions and the time of hospitalization were compared between the two groups. Results The average amount of blood loss during operation in group B was (76. 5±15. 8) ml,significantly lower than that in group A((99. 8±20. 7) ml),and the operation time in group B was (71. 2±10. 7) min,shorter than that in group A ((90. 1±18. 4) min) The difference was statistically significant (t=1. 788、2. 878,P<0. 05). At 5 minutes,30 minutes and 180 minutes after medication, the systolic blood pressure of patients in group A was (132. 2±1. 4) mmHg,(120. 7±5. 3) mmHg,(110. 9±1. 8) mmHg and the diastolic blood pressure was (80. 9 ±12. 5) mmHg,(71. 4±12. 6)mmHg,(70. 1±2. 8) mmHg,while the systolic blood pressure in the group B was (140. 4±11. 1) mmHg,(131. 2±4. 5) mmHg,(121. 4±11. 2) mmHg and the diastolic blood pressure was (93. 4±8. 1) mmHg,(86. 4±7. 1) mmHg,(81. 1±1. 5) mmHg,the differences were statistically significant (systolic blood pressureFtime=68. 57,P<0. 001;FgrouP=16. 54,P<0. 001;Finteraction=4. 34,P=0. 011;diastolic blood pressureFtime=45. 16,P<0. 001;FgrouP=10. 79,P=0. 024;F interaction=4. 16,P=0. 037);at the same treatment time,the systolic blood pressure and diastolic blood pressure in group B were higher than those in group A,the differences were statistically significant (P<0.05).Conclusion Laparoscopic uterine myomectomy with oxytocin hemostasis, intrauterine myoma wall injection method can significantly reduce intraoperative blood loss and shorten the operation time,the effect is obviously better than intravenous drip,and it is conducive to the operation.