缩宫素对子宫肌瘤血管作用的量效关系研究

Dose-effect research on the effect of Oxytocin on vessels of uterine fibroids

摘要:

目的：比较不同剂量缩宫素对子宫肌瘤血管作用的量效关系。方法：对拟行超声消融治疗的120名子宫肌瘤患者，随机分成3组，分别以0.12、0.24、0.36 U/min缩宫素剂量持续静滴，通过彩色多普勒超声观察肌瘤供血动脉在静滴缩宫素前后的变化，比较3组患者静滴缩宫素前后肌瘤供血动脉血流量变化的差异。静滴中监测患者生命体征，随访患者3个月内的血压等指标及不良反应。结果：不同缩宫素剂量的3组患者肌瘤供血动脉均出现收缩期峰值流速、平均血流速度、直径和血流量的减小，而阻力指数增大，与静滴前比较差异有统计学意义（P＜0.05）；但3组患者缩宫素作用前后肌瘤供血动脉血流量变化量的比较差异无统计学意义（P ＞0.05）。3组患者均无不良反应出现。结论：缩宫素可以有效的减少肌瘤血供，0.12 U/min持续静滴可能是超声消融子宫肌瘤治疗中的合适剂量。

Abstract:

Objective：To compare the effectiveness of different dosages of Oxytocin on uterine fibroids vessels. Methods：Totally 120 patients with uterine leiomyomas were randomly divided into three groups. Oxytocin at concentrations of 0.12，0.24 U/min and 0.36 U/min were infused respectively into patients in the three groups. Fibroid feeding arteries changes before and after the intravenous in－fusion of Oxytocin were observed by using color doppler ultrasound. The differences of arterial changes responding to the use of Oxytocin in all three groups were analyzed. Indicators of blood pressure，pulse，respiration and adverse events were recorded dur－ing the procedure and within 3 months of follow-up. Results：Peak systolic velocity，mean blood flow velocity，diameter and blood flow of the fibroid feeding arteries of patients in all three group were decreased，but resistance index was increased with statistical differ－ences compared with that before the infusion（P＜0.05）. But there was no significant statistical difference of arterial changes before and after the intravenous infusion of Oxytocin among the three groups（P ＞0.05）. No adverse event was observed in all patients. Conclu－sions：Oxytocin can reduce blood supply of the fibroids. 0.12 U/min Oxytocin intravenous infusion could be the most favorable dosage for ultrasound ablation in the treatment of uterine fibroids.