腹腔镜子宫肌瘤剔除术前米非司酮预处理的临床效果观察

目的观察米非司酮预处理后行腹腔镜子宫肌瘤剔除术的效果及安全性。方法选择我院2005年5月～2010年5月拟行子宫肌瘤剔除术98例（肌瘤直径均〉5 cm）,术前应用米非司酮预处理52例纳入研究组,46例未用药者纳入对照组。两组均行腹腔镜子宫肌瘤剔除术,比较两组肌瘤直径、手术时间、术中出血量,观察研究组药物不良反应。结果研究组预处理前肌瘤平均直径（6.3±1.1）cm,预处理后（4.2±1.0）cm,预处理前、后比较差异有统计学意义（P〈0.01）;对照组术前肌瘤平均直径（5.8±1.3）cm。研究组预处理后肌瘤直径与对照组比较差异有统计学意义（P〈0.01）。研究组手术时间及出血量较对照组明显减少,差异有统计学意义（P〈0.01）。研究组用药期间全部闭经,8例出现轻微不良反应,停药后1个月恢复月经。结论对于直径〉5 cm的子宫肌瘤,腹腔镜子宫肌瘤剔除术前应用米非司酮预处理,可缩小肌瘤直径,从而缩短手术时间,减少术中出血。

Analysis of Clinical Effects of Mifepristone Agonist Therapy before Laparoscopic Hysteromyomectomy

Objective To explore the effects and safety of Mifepristone therapy before laparoscopic hysteromyomectomy.Methods A retrospective study was conducted in 98 patients with uterine fibroids undergoing laparoscopic myomectomy in our hospital during May 2005 and May 2010(diameter>5 cm).Of them,52 patients were given Mifepristone pre-treatment for 3 months before laparoscopic myomectomy,and were enrolled in the study group,46 patients without any disposal were enrolled in the control group.All patients underwent laparoscopic myomectomy.The operation time,bleeding quantity in two groups and the adverse reaction of the study group were compared.Results The average diameter of uterine fibroids in study group before pre-treatment was(6.3±1.1)cm,and was(4.2±1.0)cm after pre-treatment.The average diameter of uterine fibroids in control group was(5.8±1.3)cm.There was significant difference before and after pre-treatment in study group(P<0.01).Between the study group after pre-treatment and the control group,there was significant difference(P<0.01).The operation time and the bleeding quantity of the study group was less than that in the control group(P<0.01).During the treatment of the study group,all the patients had amenorrhea,and 8 patients had slight adverse reaction.Conclusion Pre-treatment of adminstration of Mifepristone before operation in leiomyomas(diameter>5 cm)can remarkably reduce the diameter of the leiomyomas,operation time and bleeding quantity.