| Objective:Through the study of the operative and postoperative indexes,to evaluate the hemostatic effect of the cervical isthmus ligation and intrauterine injection of Pituitrin in laparoscopic myomectomy,in order to provide scientific basis for the clinical treatment of uterine fibroids.Method:A total of 200 patients with uterine fibroids who underwent laparoscopic myomectomy in the Affiliated Hospital of Tai'an Medical College from Jan.2015 to Oct.2016 were selected as the study objects and randomly divided into study group and control group.94 cases in the study group with the application of cervical isthmus ligation,106 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,and operative complications were compared between the two groups.Result:1.Two groups of patient's age,preoperative hemoglobin level,clinical symptoms,number of myomas,the maximum tumor diameter,the mean tumor diameter uterine position and other aspects of comparison,had no statistical significance(P>0.05).2.The average operation time of the study group(58.89±14.49)minutes,longer than that of the control group(62.13±18.31)minutes,but there was no significant difference between the two groups(P>0.05).The mean intraoperative bleeding was(64.16±20.89)ml of the study group was lower than that of the control group(68.42±24.07)ml,but there was no significant difference between the two groups(P>0.05).The postoperative hemoglobin decline level of the study group was(1.51±0.55)g/L and was lower than that of the control group(1.57±0.63)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(6.05±1.31)d was shorter than that of the control group(6.14±1.63)d,but there was no significant difference between the two groups(P>0.05).The postoperative anal exhaust time(21.46±5.02)h in the study group was significantly longer than that in the control group(17.68±4.86)h,the difference was statistically significant(P<0.05).3.The number of uterine fibroids(n?5),Two groups of patient's age,preoperative hemoglobin level,clinical symptoms,number of myomas,the maximum tumor diameter,uterine position and other aspects of comparison,had no statistical significance(P>0.05).4.The number of uterine fibroids(n?5),the average operation time of the study group(72.00±11.91)min,which was shorter than that of the control group(81.06±12.33)min,the difference between the two groups was statistically significant(P<0.05).The mean intraoperative bleeding of the study group was(80.27±19.84)ml was significantly lower than that of the control group(112.36±20.47)ml,and the difference was statistically significant(P<0.05).The postoperative hemoglobin decline level of the study group was(2.12±0.48)g/L was lower than that in the control group(3.13±0.51)g/L,and the difference was statistically significant(P<0.05).The average postoperative hospital stay of the study group was(6.45±1.39)d,which was shorter than that of the control group(6.79±1.82)d,but there was no significant difference between the two groups(P>0.05).The postoperative anal exhaust time(21.00±5.30)h in the study group was longer than that in the control group(16.30±4.65)h,and the difference was statistically significant(P<0.05).Conclusion:In the laparoscopic myomectomy surgery,intraoperative use of cervical isthmus ligation and intrauterine injection of posterior pituitary can effectively reduce intraoperative bleeding,shorten the operation time.When the maximum tumor diameter is less than 10 cm and the number of uterine fibroids is less than or equal to 4,the hemostatic effect of the use of cervical isthmus ligation and the intrauterine injection of posterior pituitary hormone during the laparoscopic myomectomy is in no significant difference.When the number of uterine fibroids is greater than or equal to 5,the hemostasis effect of using cervical isthmus ligation is better than using intrauterine injection of pituitary in laparoscopic myomectomy.The cervical isthmus ligationcan can significantly reduce the bleeding during operation,shorten operation time,reduce the decline range of hemoglobin after operation,and the postoperative intestinal function can recover quickly,especially for patients with cardiovascular and metabolic disease,worthy of clinical application.However,intra-operative cervical isthmus ligation has its limitations,can not completely replace the intrauterine injection of pituitrin. |
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