Saha Mriganka Mouli, Biswas Subhash Chandra, Alam Hajekul, Kamilya Gouri Sankar, Mukhopadhyay Madhumita, Mondal Sarbeswar
Senior Resident, Department of Obstetrics and Gynaecology, IPGME&R , Kolkata, West Bengal, India .
Senior Resident, Department of Obstetrics and Gynaecology, AIIMS , Patna, Bihar, India .
J Clin Diagn Res. 2016 May;10(5):QC10-3. doi: 10.7860/JCDR/2016/17484.7789. Epub 2016 May 1.
Myomectomy is an invasive surgical procedure. It can be associated with intraoperative and postoperative complications like excessive haemorrhage. There are various methods to control haemorrhage like pharmacological and as well as mechanical methods.
This study was taken to compare intraoperative blood loss following abdominal myomectomy after receiving intramyometrial vasopressin or tourniquet application and to estimate postoperative reduction in haemoglobin & haematocrit values.
The study was a randomised single blinded parallel group study. Total 48 patients were included in this study according to inclusion and exclusion criteria. All patients were divided into two groups i.e. 'T' and 'V' group, 24 in each group. 'T' group received conventional tourniquet application and 'V' group received intramyometrial vasopressin administration. The analyses in this study were both sided and p<0.05 was considered significant statistically. The Software used were Statistica version 6 (Tulsa, Oklahoma: Stat Soft Inc., 2001) and Graph Pad Prism version 5 (San Diego, California: Graph Pad Software Inc., 2007).
The blood loss in the tourniquet group was significantly higher (p=<0.001). Postoperative haemoglobin and haematocrit were lower in tourniquet group than vasopressin group. There was significant fall in haemoglobin and haematocrit in postoperative period in both group (p=<0.001) but it was more in tourniquet group. Total five patients (three in tourniquet group and two in vasopressin group) had received one unit whole blood transfusion.
Intramyometrial vasopressin injection during myomectomy operation more effectively decreases the blood loss, need for blood transfusion and it causes less reduction in haemoglobin and haematocrit. Thereby it seems to be an effective method without having any risk of ischemic damage to the uterus.
子宫肌瘤切除术是一种侵入性外科手术。它可能与术中及术后并发症相关，如大出血。有多种控制出血的方法，如药物方法和机械方法。
本研究旨在比较接受肌层内注射血管加压素或使用止血带的腹部子宫肌瘤切除术后的术中失血量，并评估术后血红蛋白和血细胞比容值的降低情况。
本研究为随机单盲平行组研究。根据纳入和排除标准，共有48例患者纳入本研究。所有患者分为两组，即“T”组和“V”组，每组24例。“T”组接受传统止血带应用，“V”组接受肌层内注射血管加压素。本研究的分析为双侧分析，p<0.05被认为具有统计学意义。使用的软件为Statistica 6版（俄克拉荷马州塔尔萨：Stat Soft公司，2001年）和Graph Pad Prism 5版（加利福尼亚州圣地亚哥：Graph Pad软件公司，2007年）。
止血带组的失血量显著更高（p=<0.001）。止血带组术后血红蛋白和血细胞比容低于血管加压素组。两组术后血红蛋白和血细胞比容均显著下降（p=<0.001），但止血带组下降更多。共有5例患者（止血带组3例，血管加压素组2例）接受了1单位全血输血。
子宫肌瘤切除术中肌层内注射血管加压素能更有效地减少失血量、输血需求，且导致血红蛋白和血细胞比容降低较少。因此，它似乎是一种有效的方法，且不会有子宫缺血性损伤的风险。
