子宫肌瘤剔除术后米非司酮预防肌瘤复发的临床分析(1)
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2010年4月5日
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[摘要] 目的:探讨米非司酮预防子宫肌瘤剔除术后子宫肌瘤复发的临床效果。方法:70例子宫肌瘤患者随机分成单独手术组和联合治疗组,两组均行腹腔镜子宫肌瘤剔除术,联合治疗组患者术后接受米非司酮治疗。分析两组患者12个月时子宫肌瘤的复发情况,3个月和12个月血清雌二醇(E2)和孕激素水平。结果:3个月时联合治疗组血清雌二醇(E2)和孕激素明显低于单独手术组,而12个月时两组无明显差异,联合治疗组子宫肌瘤的复发率明显低于单独手术组。结论:子宫肌瘤剔除术后服用米非司酮可以有效地预防子宫肌瘤的复发。
[关键词] 子宫肌瘤;米非司酮;复发
[中图分类号] R713.4 [文献标识码]A [文章编号]1674-4721(2010)04(a)-013-02
Clinical research on prevention of mifepristone to recurrence of uterine fibroids after myomectomy
PAN Xuemei
(The Department of Obstetrics and Gynecology of the Dianbai Women and Children′s Hospital, Dianbai 525400, China)
[Abstract] Objective: To evaluate the mifepristone′s prevention to recurrence of uterine fibroids after myomectomy. Methods: 70 cases of uterine fibroids were randomly divided into surgery group and combined treatment group,both groups underwent laparoscopic myomectomy,the patients of the combined treatment group received postoperative treatment with mifepristone. All patients were analysis of recurrence in 12 months,the serum level of estradiol(E2) and progesterone hormone in 3 months and 12 months after surgery. Results: After 3 months,the serum level of estradiol(E2) and progesterone of the combined treatment group were significantly lower than that of the surgery group.After 12 months,there were no significant difference between the two groups.Recurrence rate of the combined treatment group was significantly lower than that of the surgery group. Conclusion: Mifepristone may be effective in preventing the recurrence of uterine fibroids after myomectomy.
[Key words] Uterine fibroids; Mifepristone; Recurrence
子宫肌瘤是育龄妇女最常见的良性肿瘤,发病率为25%左右[1-2]。子宫肌瘤剔除术后肌瘤再发率高,子宫全切术是防止复发最有效的方法。但当前子宫肌瘤患病呈现出年轻化的趋势,为此患者往往要求采用保留子宫机能的肌瘤剔除治疗方式[3]。为此,如何预防术后复发成为当前子宫肌瘤治疗的难题。本次研究对子宫肌瘤患者在肌瘤剔除术后应用米非司酮以预防子宫肌瘤复发,探讨其疗效及可行性,现报道如下:
1 资料与方法
1.1 一般资料
2005年6月～2009年6月资料保存完整的子宫肌瘤患者70例,年龄29～59岁,平均(41.7±8.3)岁,均经B超确诊为子宫肌瘤,排除子宫内膜及颈管内恶性病变,随访12个月。患者随机分成单独手术组和联合治疗组,每组35例,两组患者年龄、子宫肌瘤大小和个数相比,差异无统计学意义(P>0.05),具有可比性。
1.2 治疗方法
两组均行腹腔镜子宫肌瘤剔除术,联合治疗组患者术后接受米非司酮治疗。治疗方法为:米非司酮[上海医药(集团)有限公司新华联制药厂,国药准字H10950202]25 mg,自月经第1～2天开始服用,每晚睡前服,连服3个月为1个疗程,根据病情用药1～2个疗程后停药,随访1年。对照组未服用相关药物。
1.3 观察指标
治疗组与对照组在术前、术后6、12个月卵泡期复诊查血清雌二醇(E2)和孕激素,记录患者子宫肌瘤复发和月经情况。
1.4 统计学方法
计量资料用x±s表示,进行t检验,计数资料用χ2检验,P<0.05为差异有统计学意义。
2 结果
2.1 子宫肌瘤复发情况
经过12个月随访,单独手术组子宫肌瘤复发8例(22.9%),联合治疗组3例(8 ......
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