Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Egypt.
Int J Gynaecol Obstet. 2010 Mar;108(3):233-5. doi: 10.1016/j.ijgo.2009.09.022. Epub 2009 Nov 27.
To compare the effectiveness of preliminary uterine artery ligation versus pericervical mechanical tourniquet in reducing hemorrhage during myomectomy.
A total of 103 patients undergoing myomectomy were randomly allocated to undergo preliminary uterine artery ligation (52 patients) or pericervical tourniquet (51 patients). The primary outcome measure was estimated blood loss. Secondary outcomes included duration of the operation, duration of hospital stay, postoperative hemoglobin, and the need for postoperative analgesia.
Operative blood loss was significantly less with uterine artery ligation compared with tourniquet (433.80+/-285.21 vs 823.23+/-237.33mL, P<0.001). The mean duration of the operation was lower in the uterine artery ligation group compared with the tourniquet group (50.5+/-8.7 vs 76.3+/-9.4 minutes, P<0.001). Postoperative hospital stay was significantly shorter in the uterine artery ligation group compared with the tourniquet group (4.1+/-0.1 vs 5.1+/-0.2 days; P<0.001). Postoperative hemoglobin concentrations and the need for postoperative analgesia were higher in the uterine artery ligation group (P=0.012 and P<0.001, respectively).
Uterine artery ligation was more effective than pericervical tourniquet as a preliminary step in reducing blood loss during abdominal myomectomy.
比较子宫动脉初步结扎与宫颈机械止血带在减少子宫肌瘤剔除术中出血的效果。
将 103 例行子宫肌瘤剔除术的患者随机分为子宫动脉结扎组（52 例）和宫颈止血带组（51 例）。主要观察指标为估计失血量。次要观察指标包括手术时间、住院时间、术后血红蛋白和术后镇痛需求。
与止血带相比，子宫动脉结扎组术中出血量明显减少（433.80+/-285.21 比 823.23+/-237.33mL，P<0.001）。子宫动脉结扎组的手术时间明显短于止血带组（50.5+/-8.7 比 76.3+/-9.4 分钟，P<0.001）。子宫动脉结扎组的术后住院时间明显短于止血带组（4.1+/-0.1 比 5.1+/-0.2 天；P<0.001）。子宫动脉结扎组术后血红蛋白浓度和术后镇痛需求均较高（P=0.012 和 P<0.001）。
子宫动脉结扎作为减少腹部子宫肌瘤剔除术出血的初步步骤，比宫颈机械止血带更有效。
