手术前后小剂量应用米非司酮对子宫肌瘤手术的效果影响

目的：探究手术前后小剂量应用米非司酮对子宫肌瘤手术的效果影响。方法选取2011年1月至2013年1月来本院就诊的行手术治疗子宫肌瘤患者180例，依据分层随机分组法将患者分为治疗组、对照组和空白组，每组60例。对照组在术前100 d开始小剂量服用米非司酮直至手术时和术后停止；治疗组在对照组的基础上术后小剂量服用米非司酮6个月；空白组患者仅给予安慰剂处理，处理结束后给予常规手术治疗。结果患者初诊时子宫肌瘤大小、孕酮及雌激素水平比较差异无统计学意义（P＞0．05）；用药后，治疗组及对照组患者术前的子宫肌瘤及孕酮明显小于空白组，差异有统计学意义（P＜0．05）；治疗组及对照组患者的术中出血量、阴道流血时间、手术时间、术后出现发热例数、术后疼痛时间及住院时间明显低于空白组，差异有统计学意义（P＜0．05）。治疗组及对照组肿瘤组织中孕激素受体水平（PR）、表皮生长因子受体（EGFR）水平均低于空白组，差异有统计学意义（P＜0．05）；术后治疗组患者月经恢复时间明显高于对照组及空白组，差异有统计学意义（P＜0．05）；术后6个月治疗组患者孕酮水平明显低于对照组及空白组，差异有统计学意义（ P＜0．05）；术后6个月及12个月后治疗组患者的子宫肌瘤复发例数明显低于对照组及空白组（P＜0．05）。结论术前小剂量应用米非司酮可显著抑制肿瘤的发展、缩小子宫肌瘤大小、降低术中出血、促进术后恢复，术后使用小剂量的米非司酮可明显降低患者术后复发率。

The effects of taking small doses of mifepristone before and after surgery for patients with uterine fibroids

Objective To explore The effects of the results of surgery for patients with uterine fibroids taking small doses of Mifepristone before and after surgery .Methods 180 cases of uterine fibroids patients were selected which come to our hospital from January 2011 to January 2013 for treatment .The patients were divided into treat-ment group ,control group and blank group according to the stratified randomization method .There were 60 cases of patients in each group .The control group accepted the small doses of mifepristone for 100 days until surgery and the treatment group accepted small doses of mifepristone for 6 months after surgery .The blank group accepted placebo from 100 days before until 6 months after surgery .Then all of the patients accepted operation for treatment .Results There was no statistically significant difference of the size of uterine fibroids ,progesterone and estrogen level of the both groups at the first time for treatment （P〉 0 .05） .The size of uterine fibroids and progesterone of treatment group and control group were significantly less than the blank group in the preoperative （P 〈0 .05 ） .The blood loss during the operation ,the numbers of days vaginal bleeding ,operative time ,the number of cases of postoperative fe-ver ,the days of the postoperative pain and the days of hospitalization of the treatment group and control group were all significantly lower than the blank group （P〈 0 .05） .The levels of tumor tissue levels of progesterone receptor （PR） and epidermal growth factor receptor（EGFR） of the treatment group and control group were still lower than the blank group（P〈0 .05） .The menstruation returned days after the surgery of the treatment group were signifi-cantly higher than the control group and the blank group （P〈0 .05）;.The progesterone levels of the treatment group was significantly lower than the control group and blank group six months after of treatment （P〈0 .05）;The recur-rence of the treatment group was significantly lower tha