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中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2013, Vol. 09 ›› Issue (05): 632 -635. doi: 10.3877/cma.j.issn.1673-5250.2013.05.014

Special Issue: ；

Original Article

Clinical Studies of Oxytocin Pretreatment in Treatment of Submucosal Uterine Fibroids by Hysteroscopic Transurethral Resection

Zhao-rong GUO1, Zhong-ye WANG1()   

  1. 1. Department of Gynaecology and Obstetrics, the Affiliated Wendeng Central Hospital of Weifang Medical College, Wendeng 264400, Shandong Province, China
  • Received:2013-06-09 Revised:2013-09-10 Published:2013-10-01
  • Corresponding author: Zhong-ye WANG
  • About author:
    (Corresponding author: WANG Zhong-ye, Email: )
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Objective

To explore the feasibility and value of oxytocin pretreatment in the treatment of submucosal uterine fibroids by use of hysteroscopic transcervical resection of myoma(TCRM).

Methods

From February 2005 to October 2009, a total of 122 cases of patients with submucosal uterine fibroids undergoing hysteroscopic TCRM were included in this study. According to whether oxytocin pretreatment before TCRM or not, they were divided into oxytocin pretreatment group(n=60, oxytocin pretreatment before TCRM) and control group (n=62, did not pretreatment by oxytocin before TCRM). Electrocision was underwent 3 days after intramuscular injection of oxytocin for oxytocin pretreatment group, however electrocision was underwent directly for control group. Average duration of operation, intraoperative blood loss volume, liquosorption volume and postoperative hospitalization time between two groups were analyzed by statistical method. Then postoperative improvement of symptoms and pregnancy were followed up and analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Affiliated Wendeng Central Hospital of Weifang Medical College. Informed consent was obtained from all participants. There had no significance difference between two groups among average age, incidence rate of moderate to severe anemia and adverse pregnancy history and general degree of clinical symptoms(P>0.05).

Results

There had significance difference between two groups among average duration of operation, intraoperative blood loss volume, liquosorption volume and postoperative hospitalization time (P<0.05). After following up for (22.35±1.34) months, there had no significance difference between two groups in respect of changes of menstrual volume, improvement of irregular vaginal bleeding symptom and pregnancy rates(P>0.05), but recurrence rates of residual fibroids in oxytocin pretreatment group were reduced much more than those in control group(P<0.05).

Conclusions

Applying oxytocin pretreatment before use of hysteroscopic TCRM may shorten average duration of operation and postoperative hospitalization time, decrease blood loss volume and liquosorption volume, reduce the recurrence rates of residual fibroids.

Key words: oxytocin pretreatment, submucosal uterine fibroids, hysteroscopic transurethral resection
表1 两组患者平均手术时间、术中出血量、液体吸收量及术后住院天数等比较(±s)
Table 1 Comparison of average duration of operation，intraoperative blood loss volume, liquosorption volume and postoperative hospitalization time between two groups(±s)
组别 n 平均手术时间(min) 术中出血量(mL) 液体吸收量(mL) 术后住院天数(d)
预处理组 60 13.09±3.02 20.13±8.03 172.30±26.83 3.12±0.18
对照组 62 16.52±2.82 29.59±7.12 246.41±28.45 4.52±0.26
t ? 2.7510 3.2980 3.0960 3.4840
P ? 0.0073 0.0016 0.0042 0.0022
表2 两组完成随访研究患者的月经改变及不规则阴道流血症状改善情况、术后2年内妊娠率比较[n(%)]
Table 2 Comparison of improvement of changes of menstruation, irregular vaginal bleeding symptom and rates of pregnancy in 2 years follow-up after surgery between two groups[n(%)]
组别 n 月经量改变情况 不规则阴道流血 残余肌瘤复发率 妊娠率
增多 无改变 减少 无改变 减少 消失 增大 无改变 缩小/消失 妊娠 未妊娠
预处理组 58 3(5.2) 6(10.3) 49(84.5) 4(6.9) 8(13.8) 46(79.3) 4 (6.9) 9(15.5) 45(77.6) 7(70.0) 3(30.0)
对照组 59 4(6.8) 8(13.6) 47(79.7) 5(8.5) 9(15.3) 45(76.2) 8(13.6) 18(30.5) 33(55.9) 6(60.0) 4(40.0)
χ2 ? 0.4617 0.1724 6.1714 0.2198
P ? 0.7938 0.9174 0.0457 0.6392
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