Efficacy Of Using Methyl Carprost Suppository In Laparoscopic Myomectomy

Myomas,are also known as fibroids.Two-thirds of women with fibroids are often symptomless but the remaining third present with symptoms that are severe enough to warrant removing the myomas surgically.Laparoscopic myomectomy is a priority approach for women with fibroids who are considering future childbearing.The control of bleeding during the performance of the procedure is safe and effective.Skillful surgical techniques may decrease operative blood loss and blood transfusion rate,and the results will be better when combined with other hemorrhage-reducing approaches.This study provides a theoretical basis for clinical application in laparoscopic myomectomy.Objective:Our study will assess the clinical safety and effectiveness of methyl carprost suppository in laparoscopic myomectomy.Methods :The clinical date of 80 patients,who were scheduled for laparoscopic myomectomy due to symptomatic uterine myomas,in Qingdao Women and Children 's Hospital Gynecological Center.The patients were randomly divided into two groups.There are 40 patients in A group including 22 cases with multiple myomata and 18 cases with sigle myomata,who were placed carprost at pin 1 mg after vaginal fornix,endotracheal intubateion after general anesthesia(carboprost group).And there are 40 patients in B group includeing 23 cases with multiple myomata and 17 cases with sigle myomata,who were intramyometrially injected with 6 IU vasopressin diluted with 10 ml saline solution prior to intraoperative incision size film layer(vasopressin group).Did the surgery of laparoscopic myomectomy according to conventional under tracheal intubation anesthesia and give continuous ecg monitoring.Compare the significance in amount of hemorrhage,the procedure time,postoperative reduction in hemoglobin levels,changes in systolic blood pressur,diastolic blood pressure and heart rate(including before medication,medication after 10 min,30 min after medication and surgery after 3 days),and bowel deflation time after laparoscopic myomectomy.Results:All the lesions were treated by suegical means successfully,with no convertion to laparotomy and no complication occurred.1.The average blood lost during the operation of 2 groups is 84.7±63.9ml and 87.1±52.6ml,the postoperative hemoglobin reduction is 22.3±17.0g/L and 19.3±20.6g/L,and the average operating time is 93.3±40.0min and 117.3±37.9min.There were no evident differences between the vasopressin and carboprost groups regarding procedure time,amount of hemorrhage and postoperative hemoglobin reduction(P >0.05).2.The average time of bowel deflation is27.2±2.79 h and 36.1±4.21 h,there was significantly less than those of the vasopressin group.(t=11.11,P<0.05).3.We monitored the systolic blood pressure,diastolic blood pressure and heart rate including before medication,medication after 10 min,30 min after medication and surgery after 3 days,the hemodynamic changes of the carboprost group slightly,and there was markedly superior to those of the vasopressin group.(SBP: F=43.0,P<0.05;DBP: F=64.2,P<0.05;HR:F=56.2,P<0.05).Conclutions: 1.There were no evident differences between the vasopressin and the carboprost groups regarding procedure time,amount of hemorrhage and postoperative hemogl obin.reduction.2.The times of bowel deflation of the carboprost group was significantly less than those of the vasopressin group and the hemodynamicm stability of the carboprost group markedly superior to those of the vasopressin group.3.This study proves that placing carprost at pin 1 mg after vaginal fornix prior to laparoscopic myomectomy has many characteristics,such as application of simple,convenient and less adverse sides.So,carboprost is worthy of popularization and application in the clinic.