目的探讨宫颈高频电波刀环形电切术(LEEP)手术中使用垂体后叶素减少术中出血的可行性及临床价值。方法将宫颈上皮内瘤变(CIN)行LEEP患者分为研究组和对照组各45例,研究组在LEEP术中宫颈两侧注射利多卡因加垂体后叶素,对照组在LEEP术中宫颈两侧单用利多卡因注射,比较两组患者的术中出血量和手术时间。结果研究组患者的术中出血量明显少于对照组,手术时间显著短于对照组,两组比较,差异有统计学意义(P<0.05);研究组患者术中心率35 s达最高值,显著高于对照组,两组比较,差异有统计学意义(P<0.05),其后开始下降,1 min、5 min及10 min心率比较,差异无统计学意义(P>0.05),心率属于一过性升高,无严重不良反应发生;两组血压比较,差异无统计学意义(P>0.05);研究组患者的术后阴道流液、流血量及持续时间明显低于对照组,两组间比较,差异具有统计学意义(P<0.05);且研究组患者术后宫颈管狭窄、粘连、宫颈柱状上皮外翻(息肉样增生)显著高于对照组,两组间比较,差异有统计学意义(P<0.05)。结论宫颈LEEP手术中使用垂体后叶素可以明显减少手术出血,使手术操作过程更为安全迅速、简单有效,且术后并发症的发生率低。
ObjectiveTo explore the feasibility and clinical value of cervical injection of pituitrin to reduce the risk of intraoperative bleeding during c ervical loop electrosurgical excision procedure. Method90 patients with cervical intraepithelial neoplasia (CIN) undergoing LEEP surgery were divided into research group and control group, 45 cases for each. Lidocaine plus vasopressin was injected on both sides of the cervix during LEEP surgery in the research group, while lidocaine alone was used in the control group. Blood loss and operative time were compared between groups. ResultsThe blood loss of the research group was significantly less than that of the control group and the operative time of the research group was significantly shorter than that of the control group (P<0.05). The heart rate of the research group rose up to a maximum value 35 seconds during surgery, significantly higher than that of the control group, (P<0.05), Then the heart rate began to decline. The heart rates on the 1st minute, 5th minute and 10th minute during surgery showed no significant difference between groups(P>0.05). The blood pressure between two groups showed no significant difference (P>0.05). The postoperative vaginal discharge, bleeding volume and duration of hospital stay was significantly lower in the research group (P<0.05). The rates of postoperative cervical stenosis, adhesions, cervical columnar epithelium valgus (polypoid hyperplasia) in the research group were significant lower(P <0.05). ConclusionCervical injection of pituitrin during cervical loop electrosurgical excision procedure can significantly reduce the risk bleeding, worthy of clinical promotion.