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目的 探讨在腹腔镜下行子宫肌瘤剔除术时 ,使用不同的手术预处理对手术出血量的影响 ,探讨影响手术效果的相关因素。方法 1999年 10月至 2 0 0 3年 3月对广东省佛山市南海区妇幼保健院腹腔镜下 15 7例子宫肌瘤患者施行子宫肌瘤剔除术 ,随机分成 4组进行手术预处理 ,第 1组用套扎线圈先套扎宫颈峡部 ,第 2组子宫肌层注射催产素 2 0IU ,第 3组子宫肌层注射催产素 10IU加麦角新碱 0 4mg ,第 4组子宫肌层注射垂体后叶素12U ,分析不同预处理手术出血量、术后恢复的情况。结果 15 7例手术均获成功。第 4组的出血量与其它 3组相比较差异有显著性。各组手术后排气时间、术后住院时间差异不显著。结论 腹腔镜下行子宫肌瘤剔除术时 ,子宫肌层注射垂体后叶素的预处理 ,可使手术出血量明显减少。术中配合腹部B超检查可防止多发性子宫肌瘤的遗漏
Objective To investigate the effect of different surgical preoperative treatment on the amount of surgical bleeding during laparoscopic myomectomy, and to explore the related factors that affect the surgical outcome. Methods From October 1999 to March 2003, myomectomy was performed in 157 cases of uterine fibroids underwent laparoscopy in Nanhai District of Foshan City, Guangdong Province from March 1999 to March 2003. The patients were randomly divided into 4 groups for operation pretreatment. The first group with a lasso coil ligation of the cervical isthmus, the second group of uterine myometrial injection of oxytocin 20IU, the third group of myometrial injection of oxytocin 10IU ergometrine 0 4mg, the fourth group of myometrial pituitary injection Theophylline 12U, analysis of different preoperative bleeding, postoperative recovery. Results 15 cases of surgery were successful. Bleeding volume in Group 4 was significantly different from the other three groups. The exhaust time of each group after surgery, postoperative hospital stay was not significantly different. Conclusion Laparoscopic myomectomy, myometrial injection of pituitrin pretreatment, can significantly reduce the amount of bleeding surgery. Surgery with abdominal B-ultrasound can prevent the omission of multiple uterine fibroids