Kammerer-Doak D N, Rogers R G, Johnson Maybach J, Traynor Mickelson M
Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, USA.
Am J Obstet Gynecol. 2001 Dec;185(6):1344-7; discussion 1347-8. doi: 10.1067/mob.2001.119076.
The purpose of this study was to evaluate the risk of pelvic infection with the use of vasopressin at time of vaginal hysterectomy with a randomized controlled trial.
Women who underwent vaginal hysterectomy and agreed to participate were randomly assigned to pericervical injections of vasopressin or normal saline solution. Surgeons and patients were blinded to the injected substance. Power analysis revealed that a sample size of 116 patients would be sufficient to detect a 4-fold difference in pelvic infection rates between the 2 groups, with 90% power and a probability value of.05.
Analysis with 117 patients found no difference in infection rate between the normal saline solution group and the vasopressin groups (7.3% vs 1.6%; P =.19). Estimated blood loss (312 +/- 222 mL vs 446 +/- 296 mL; P =.006) and change in hemoglobin and hematocrit levels (2.1 +/- 1.4 gm vs 2.9 +/- 1.4 gm; P: =.02; and 6.7% +/- 3.4% vs 8.5% +/- 3.8%; P =.01; vasopressin versus normal saline solution, respectively) were significantly less in the vasopressin group. There were no significant differences in interval blood pressure measurements after vasopressin administration between the 2 groups.
The use of vasopressin during vaginal hysterectomy does not increase the risk of pelvic infection, does decrease operative blood loss, and does not significantly affect blood pressure.
本研究旨在通过一项随机对照试验评估在阴道子宫切除术中使用血管加压素导致盆腔感染的风险。
接受阴道子宫切除术并同意参与的女性被随机分配接受宫颈周围注射血管加压素或生理盐水。外科医生和患者对注射的物质均不知情。功效分析表明，样本量为116名患者足以检测出两组之间盆腔感染率4倍的差异，功效为90%，概率值为0.05。
对117名患者的分析发现，生理盐水组和血管加压素组的感染率无差异（7.3%对1.6%；P = 0.19）。血管加压素组的估计失血量（312±222毫升对446±296毫升；P = 0.006）以及血红蛋白和血细胞比容水平的变化（分别为2.1±1.4克对2.9±1.4克；P = 0.02；以及6.7%±3.4%对8.5%±3.8%；P = 0.01；血管加压素组对生理盐水组）显著更低。两组在注射血管加压素后各时段血压测量值无显著差异。
阴道子宫切除术中使用血管加压素不会增加盆腔感染风险，确实会减少手术失血量，且不会显著影响血压。
