1.Study on hemostatic effect of different administration methods of hemabate in laparoscopic myomectomy
Congzhe WU ; Yingxin ZHANG ; Xin ZHAO ; Ming LIU ; Wenzhe ZHAO ; Heng REN ; Haipeng LI
Clinical Medicine of China 2017;33(10):882-886
Objective To investigate the hemostatic effect of different administration Methods of hemabate in laparoscopic myomectomy, and to clarify the best mode of hemabate in laparoscopic myomectomy.Methods Ninety patients were randomly divided into two groups,group A and group B,45 patients in each group,group A was given intramuscular injection of hemabate 0.25 mg 30 minutes before operation,and in group B,the patients were injected with hemabate 0.25 mg at the muscular wall of uterine leiomyoma during operation.The preoperative,postoperative basic situation,intraoperative blood loss,operation time,intraoperative and postoperative adverse reactions and length of hospital stay were compared between the two groups.Results The average amount of blood loss during operation in the group B was(67.6±17.6)ml, significantly less than that in the group A((88.7±21.6)ml),the operation time in the group B was(68.1 ±18.1)min,shorter than that in the group A(83.1 ± 17.5)min(t=1.877,2.787,P<0.05).The systolic blood pressure of patients in the group A after 15,30,45 and 180 minutes of medication were(155.6±10.31) mmHg,(141.2±5.7)mmHg,(138.6±10.3)mmHg,(127.5±7.4)mmHg,respectively and the diastolic blood pressure were(90.5±8.8)mmHg,(85.5±8.0)mmHg,(80.6±6.3)mmHg,(72.2±7.1)mmHg,while the systolic blood pressure were(141.1±8.3)mmHg,(120.5±6.1)mmHg,(125.7±4.6)mmHg,(118.8±5.5) mmHg and diastolic blood pressure were(81.2 ± 11.4)mmHg,(70.4 ± 10.1)mmHg,(71.5 ± 5.8)mmHg, (66.5±1.2)mmHg in the group B,the differences were statistically significant(systolic blood pressure,Ftime=79.75,P<0.001;FgrouP=25.45,P<0.001; Finteraction=5.48,P=0.041; diastolic blood pressure,Ftime=46.61,P<0.001;FgrouP=11.97,P=0.021,Finteraction=4.05,P=0.034).Conclusion The application of hemabate for hemostasis in laparoscopic myomectomy surgery and uterine fibroids at the muscle wall injection medication can significantly reduce the amount of blood loss during operation,shorten the operation time,and at the same time,the effect on blood pressure was lower than that by preoperative hemabate,is beneficial to the development of operation,with obvious advantages.
2.Study on hemostatic effect of different methods of oxytocin in laparoscopic myomectomy
Congzhe WU ; Yingxin ZHANG ; Xin ZHAO ; Ming LIU ; Heng REN ; Wenzhe ZHAO ; Haipeng LI
Clinical Medicine of China 2018;34(2):118-121
Objective To examine the hemostatic effect of oxytocin in laparoscopic myomectomy,and to clarify the optimal dosage of oxytocin in laparoscopic myomectomy. Methods From January 2016 to July 2017, ninety patients with myoma of uterus who underwent laparoscopic myomectomy in Tangshan Union Medical College Hospital were divided into two groups: group A and group B,45 cases in each group. In group A,the patients were given 20U oxytocin and 5% glucose injection 250 ml via intravenous drip, and in group B, the patients were injected with 20U oxytocin on the muscular wall of uterus myoma during operation. The preoperative, postoperative basic situation, intraoperative blood loss, operation time, intraoperative and postoperative adverse reactions and the time of hospitalization were compared between the two groups. Results The average amount of blood loss during operation in group B was (76. 5±15. 8) ml,significantly lower than that in group A((99. 8±20. 7) ml),and the operation time in group B was (71. 2±10. 7) min,shorter than that in group A ((90. 1±18. 4) min) The difference was statistically significant (t=1. 788、2. 878,P<0. 05). At 5 minutes,30 minutes and 180 minutes after medication, the systolic blood pressure of patients in group A was (132. 2±1. 4) mmHg,(120. 7±5. 3) mmHg,(110. 9±1. 8) mmHg and the diastolic blood pressure was (80. 9 ±12. 5) mmHg,(71. 4±12. 6)mmHg,(70. 1±2. 8) mmHg,while the systolic blood pressure in the group B was (140. 4±11. 1) mmHg,(131. 2±4. 5) mmHg,(121. 4±11. 2) mmHg and the diastolic blood pressure was (93. 4±8. 1) mmHg,(86. 4±7. 1) mmHg,(81. 1±1. 5) mmHg,the differences were statistically significant (systolic blood pressure:Ftime=68. 57,P<0. 001;FgrouP=16. 54,P<0. 001;Finteraction=4. 34,P=0. 011;diastolic blood pressure:Ftime=45. 16,P<0. 001;FgrouP=10. 79,P=0. 024;F interaction=4. 16,P=0. 037);at the same treatment time,the systolic blood pressure and diastolic blood pressure in group B were higher than those in group A,the differences were statistically significant (P<0.05).Conclusion Laparoscopic uterine myomectomy with oxytocin hemostasis, intrauterine myoma wall injection method can significantly reduce intraoperative blood loss and shorten the operation time,the effect is obviously better than intravenous drip,and it is conducive to the operation.
3.Effect of low-frequency pulsed electromagnetic field combined with whole-body vibration on bone density and mechanics performance of disuse osteoporosis rats
Xifang LIU ; Minyi YANG ; Guodong HUI ; Dongsheng LIANG ; Congzhe ZHAO ; Weihua HAN ; Yixin SONG ; Lijuan ZHANG
Chinese Journal of Orthopaedics 2018;38(22):1384-1391
Objective To discuss the effect of low-frequency pulsed electromagnetic field (ELF-PEMFs) combined with-whole-body vibration(WBV) on the bone mineral density,bone microstructure and the biological mechanics performance inhindlimb unloading osteoporosis rats.Methods Forty female 4 months aged SD rats were randomly divided into five groups:blank group,control group,ELF-PEMFs group,WBV group,low-frequency pulsed electromagnetic field combined with wholebody-vibration(ELF-PEMFs + WBV) group.The blank group was the normal control which comprise the healthy rats.The controlgroup was the disused osteoporosis model.Except for the blank group,thehind limb unloading rats were kept for six weeks.No intervention were provided to the blank group and the control group,other three groups were treated with physical therapy.The bodyweight of rats in each group was record.Bone mineral density was measured by Dual energy X-ray absorptiometry.The right femurs was analyzed by Micro-CT and the left femur was tested through a biomechanical machine.Results After 8 weeks of continuous treatment,the ELF-PEMFs group,WBV group,ELF-PEMFs+WBV group were significantly increased in weight and bonedensity (PELF-PEMFs=0.015,PWBV=0.016,PELF-PEMFs+WBV=0.007),(tELF-PEMFs=5.956,PELF-PEMFs=0.000;tWBV=6.127,PWBV=0.000;tELF-PEMFs+WBV=4.639,PELF-PVMFs+WBV=0.000).The difference was statistically significant (F=0.091,P=0.018).The ELF-PEMFs +WBV group was significantly higher in bone formation index.The items of BV/TV,Tb.N,Tb.Th and SMI in Micro-CT analysis increased,while Tb.Sp and Conn.D index decreased significantly.Trabecular bone structure of all the three groups was improved,however the ELF PEMFs +WBV group was better than the other two groups (vs.ELF-PEMF group,PBV/TV=0.041,PTb.N=0.026,PTb.Th=0.009,PConn.D=0.030,PTb.Sp=0.045,PSMI=0.032;VS.WBV group,PBv/Tv=0.018,PTb.N=0.004,PTb.Th=0.022,PConn.D=0.042,PTb.Sp=0.039,PSMI=0.049).The maximum load,energy absorption and bone stiffness index in biomechanicalperformance test were improved.The combination treatment group were significantly improved (F=0.167,P=0.038).Conclusion Low-frequencypulsed electromagnetic field combined with whole body vibration therapy can improve bone mineral density,bone microstructureand the biological mechanics performance.They have synergistic effect and the combination therapy is better than single treatment.