| Objective:The purpose of this study was to compare the indexes of low dose and constant speed intravenous injection of Pituitrin and uterine injection of Pituitrin in laparoscopic hysteronmyomectomy.To observe the hemostatic effect and its effect on circulation in laparoscopic hysteronmyoma resection with different administration of Pituitrin.Method:A total of 100 patients with hysteromyoma who underwent laparoscopic myomectomy in the Affiliated Hospital of Tai’an Medical College from June 2017 to January 2019 were selected as the study objects and randomly divided into study group and control group.51 cases in the study group with intravenous injection of pituitrin,49 cases in the control group with the application of intrauterine injection of Pituitrin.The clinical data were collected and the differences of intraoperative blood loss,operation time,postoperative hemoglobin decline level,postoperative anal exhaust time,postoperative hospital stay,operative complications and changes of cardiopulmonary function were compared between the two groups.Result:1.Two groups of patient’s age,history of pelvic surgery,clinical symptoms,the maximum myoma diameter,number of myomas,uterine position,preoperative hemoglobin level and other aspects of comparison,had no statistical significance.(P>0.05).2.The average operation time of the study group(59.76±16.52)minutes,shorter than that of the control group(64.08±17.62)minutes,but there was no significant difference between the two groups(P>0.05).The mean intraoperative bleeding was(63.24±19.78)ml of the study group was lower than that of the control group(67.41±23.34)ml,but there was no significant difference between the two groups(P>0.05).The postoperative hemoglobin decline level of the study group was(13.21±5.63)g/L was lower than that of the control group(14.63±7.14)g/L,but there was no significant difference between the two groups(P>0.05).The average postoperative hospital stay of the study group was(6.33±1.47)d was shorter than that of the control group(6.46±1.52)d,but there was no significant difference between the two groups(P>0.05).The postoperative anal exhaust time(18.73±5.34)h in the study group was significantly shorter than that in the control group(19.73±6.27)h,but there was no significant difference between the two groups(P>0.05).3.Surgical complications: There were no complications in intravenous drip group and uterine body group,such as injury of peripheral organs and accident of heart,brain and blood vessel.The incidence of postoperative fever was 4.00% in the study group and2.00% in the control group.There was no significant difference between the two groups(P>0.05).There were 23 cases in the study group and 31 cases in the control group when the blood pressure increased more than 30%.The blood pressure returned to normal after anesthesia intervention,the difference was statistically significant(P<0.05).4.The operative time≤60minutes,The average number of uterine myoma in the study group was(2.25±0.99),while that in the control group was(2.30±1.12),there was no significant difference between the two groups(P>0.05).The average operation time of the study group(51.62±8.38)minutes,which was slightly shorter than that in the control group(52.73±7.27)minutes,there was no significant difference between the two groups(P>0.05).The mean intraoperative bleeding of the control group was(55.31±17.53)ml was slightly less than that in the study group(56.74±23.64)ml,and there was no significant difference between the two groups(P>0.05).The postoperative hemoglobin decline level of the control was(11.04±4.12)g/L was slightly less than that in the study group(12.23±5.01)g/L,but there was no significant difference between the two groups(P>0.05).The average postoperative hospital stay of the study group was(5.93±1.31)d was significantly longer than that in the control group(5.72±1.27)d,but there was no significant difference between the two groups(P>0.05).The postoperative anal exhaust time(19.45±4.32)h in the study group was shorter than that in the control group(20.36±4.81)h,but there was no significant difference between the two groups(P>0.05).5.The operative time≤60 minutes,The blood pressure and the heart rate at 1minute before injection was no significant difference between the two groups(P>0.05).At 1minute,2 minutes,3 minutes,5 minutes,10 minutes and 20 minutes after injection,the blood pressure and heart rate in the study group were significantly lower than those in the control group(P<0.05).The blood pressure and the heart rate at 30 minute after injection was no significant difference between the two groups(P>0.05).6.The operative time>60minutes,The average number of uterine myoma in the study group was(7.12±1.67),while that in the control group was(6.76±1.54),but there was no significant difference between the two groups(P>0.05).The average operation time of the study group(71.26±12.03)min,which was shorter than that of the control group(82.44±13.27)min,the difference between the two groups was statistically significant(P<0.05).The mean intraoperative bleeding of the study group was(81.32±18.93)ml was significantly lower than that of the control group(94.01±21.38)ml,and the difference was statistically significant(P<0.05).The postoperative hemoglobin decline level of the study group was(15.68±5.74)g/L was lower than that in the control group(19.62±9.21)g/L,and the difference was statistically significant(P<0.05).The average postoperative hospital stay of the study group was(6.57±1.42)d,which was shorter than that of the control group(6.96±1.54)d,but there was no significant difference between the two groups(P>0.05).The postoperative anal exhaust time(18.25±4.94)h in the study group was longer than that in the control group(18.25±4.94)h,but there was no significant difference between the two groups(P>0.05).7.The operative time>60minutes,there was no obvious blood pressure fluctuation in the study group after 30 minutes of administration.In the control group,there were 9 patients who needed the second injection of pituitrin,and 9 patients showed obvious blood pressure fluctuation again.The difference was statistically significant(P<0.05).The blood pressure and the heart rate at 1minute before injection was no significant difference between the two groups(P>0.05).At 1 minute,2 minutes,3 minutes,5 minutes,10 minutes and 20 minutes after injection,the blood pre-ssure and heart rate in the study group were significantly lower than those in the control group(P<0.05).The blood pressure and the heart rate at 30 minute after injection was no significant difference between the two groups(P>0.05).Conclusion:1.In laparoscopic hysteromyomectomy,intravenous infusion of Pituitrin has less fluctuation of blood pressure and less influence on the body than that of uterine injection of Pituitrin.2.With the prolongation of operation time,the hemostatic effect of intravenous infusion of Pituitrin was similar or even better than that of uterine injection,and the dosage was accurate,which could reduce the total dosage of Pituitrin during operation to a certain extent.3.Suggestion:(1)when the number of myoma is ≤4,the required operation time is less than 60 minutes,or when the second uterine injection of Pituitrin is not required,both hemostatic methods can be selected after excluding contraindications.(2)when the number of myoma is more than 4,When the operation time is more than 60 minutes,or the second uterine injection of Pituitrin is required,the hemostatic method of intraoperative intravenous infusion of Pituitrin can be adopted after excluding contraindications. |
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