Corson S L, Brooks P G, Serden S P, Batzer F R, Gocial B
Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Pennsylvania Hospital, Philadelphia.
J Reprod Med. 1994 Jun;39(6):419-23.
A study was performed to assess the effect of dilute vasopressin on intraoperative bleeding and intravasation of the medium during resectoscopic hysteroscopic surgery. Dilute vasopressin or placebo was injected into the cervical stroma at the commencement of resectoscopic endometrial ablation and/or submucous myomectomy in a prospective, computer-generated, double-blind, placebo study. The operator estimated the intraoperative bleeding. The inflow volume and outflow recovered volume of sorbitol, used as a distending medium, were recorded. Pressures were kept constant with a pump. Operating time was also recorded. In 64 women the mean inflow volume was 5,584 mL (range, 500-27,000), and the mean deficit (intravasation) was 311 mL (range, 0-2,100). The mean surgical time was 37.1 minutes (range, 11-120). The deficit volume was related to the duration of surgery (P = .001) and to total inflow volume (P = .001). Increased operating time and volume infused also increase intravasation. Multivariate analysis showed that patients receiving vasopressin had a 0.36 risk of intravasation (confidence limit, 0.14-0.91) as compared with the placebo. Vasopressin injected intracervically, in conjunction with resectoscopic intrauterine surgery, reduces but does not eliminate intravasation of the medium. It also decreases intraoperative bleeding.
开展了一项研究，以评估稀释血管加压素对宫腔镜电切术中出血及术中液体外渗的影响。在一项前瞻性、计算机生成随机数字、双盲、安慰剂对照研究中，于宫腔镜子宫内膜切除术和/或黏膜下子宫肌瘤切除术开始时，向宫颈基质注射稀释血管加压素或安慰剂。术者评估术中出血量。记录作为膨宫介质的山梨醇的流入量和流出回收量。用泵维持压力恒定。同时记录手术时间。64例患者的平均流入量为5584毫升（范围500 - 27000毫升），平均液体外渗量为311毫升（范围0 - 2100毫升）。平均手术时间为37.1分钟（范围11 - 120分钟）。液体外渗量与手术持续时间（P = 0.001）及总流入量（P = 0.001）相关。手术时间延长和液体输注量增加也会增加液体外渗。多因素分析显示，与安慰剂组相比，接受血管加压素治疗的患者发生液体外渗的风险为0.36（置信区间0.14 - 0.91）。宫颈内注射血管加压素并联合宫腔镜子宫内手术，可减少但不能消除液体外渗，同时还可减少术中出血。
