Phillips D R, Nathanson H G, Milim S J, Haselkorn J S, Khapra A, Ross P L
Department of Obstetrics and Gynecology, School of Medicine, State University of New York at Stony Brook, USA.
Obstet Gynecol. 1996 Nov;88(5):761-6. doi: 10.1016/0029-7844(96)00282-7.
To assess the effect of intracervical injection of dilute (0.05 U/mL) vasopressin solution on blood loss during operative hysteroscopy.
In a randomized, double-blind study, dilute vasopressin solution or placebo (normal saline) was injected into the cervical stroma of 106 women before dilation of the cervix in preparation for operative hysteroscopy. Intraoperative bleeding was calculated by dividing the number of red blood cells per milliliter of outflow distention fluid by the number of red blood cells per milliliter of the woman's blood immediately before the procedure and multiplying this quotient by the total amount of outflow fluid collected. Pressures were kept constant with a hysteroscopic infusion pump.
The mean (+/-standard error of the mean) intraoperative blood loss of the treated (vasopressin) and control (placebo) groups was 20.3 +/- 4.1 mL (range 0-135) and 33.4 +/- 5.4 mL (range 0-290), respectively. The volume of distention fluid intravasation in the treated and control groups was 448.5 +/- 47.0 mL (range 30-1410) and 819.1 +/- 79.7 mL (range 20-1977), respectively. The operating time in the treated and control groups was 31.1 +/- 1.2 minutes (range 18-52) and 34.1 +/- 1.3 minutes (range 19-65), respectively. For all three outcome measures, the differences between the two groups were statistically significant, but for visual clarity of the uterine cavity during surgery, the difference was not significant.
Administration of dilute vasopressin solution (0.05 U/mL) to the cervical stroma significantly reduces blood loss, distention fluid intravasation, and operative time during hysteroscopy. Further evaluation is required to determine the optimum dosage.
评估宫颈内注射稀释（0.05 U/mL）加压素溶液对宫腔镜手术中失血的影响。
在一项随机双盲研究中，106名准备进行宫腔镜手术的女性在宫颈扩张前，将稀释的加压素溶液或安慰剂（生理盐水）注入宫颈基质。术中出血量通过将每毫升流出扩张液中的红细胞数量除以手术前该女性每毫升血液中的红细胞数量，再将该商乘以收集的流出液总量来计算。使用宫腔镜输液泵使压力保持恒定。
治疗组（加压素）和对照组（安慰剂）的平均（±平均标准误差）术中失血量分别为20.3±4.1 mL（范围0 - 135）和33.4±5.4 mL（范围0 - 290）。治疗组和对照组的扩张液血管内渗入量分别为448.5±47.0 mL（范围30 - 1410）和819.1±79.7 mL（范围20 - 1977）。治疗组和对照组的手术时间分别为31.1±1.2分钟（范围18 - 52）和34.1±1.3分钟（范围19 - 65）。对于所有三项结果指标，两组之间的差异具有统计学意义，但对于手术期间子宫腔的视觉清晰度，差异不显著。
向宫颈基质注射稀释的加压素溶液（0.05 U/mL）可显著减少宫腔镜手术中的失血量、扩张液血管内渗入量和手术时间。需要进一步评估以确定最佳剂量。
