不同方法治疗子宫肌瘤的临床比较

目的：探讨米非司酮药物治疗、子宫动脉栓塞术、腹腔镜子宫肌瘤剔除术治疗子宫肌瘤的临床疗效。方法：分别选取子宫肌瘤患者90例,随机分为药物治疗组、子宫动脉栓塞组、腹腔镜组各30例,药物治疗组在月经周期的第1天开始每日空腹顿服米非司酮12.5mg,3个月为1个疗程,治疗复查B超,比较治疗前后子宫体积和肌瘤数量及体积的变化;子宫动脉栓塞组,经股动脉选择性子宫动脉插管栓塞剂治疗,术后随访比较手术前后肌瘤体积的变化;腹腔镜组,手术剔除肌瘤。结果：药物治疗组子宫和肌瘤体积在应用米非司酮治疗后较治疗前明显缩小;子宫动脉栓塞组治疗后瘤体体积较术前明显缩小（成功率〉80%）;腹腔镜组子宫肌瘤剔除率达98%,术中、术后流血少,对机体损伤小。结论：3种治疗子宫肌瘤的方法各有其优缺点,药物保守治疗可用于年轻有生育要求的妇女避免手术,对于多发性子宫肌瘤或瘤体较大者可采用腹腔镜下子宫肌瘤剔除术。

Clinical comparison of different methods for the treatment of uterine fibroids

Objective： To explore the treatment of mifepristone, uterine artery embolization, laparoscopic myomectomy in treatment of uterine fibroids. Methods： 90 cases of uterine myoma patients were selected and were randomly divided into drug treatment group, uterine artery embolization group, the laparoscopic group. Drug treatment group were given mifepristone 12.5 mg daily, fasting dayton, start from the menstrual cycle first day, a course of 3 months, reviewed B ultrasound. Uterine volume, number and size of myomas change were compared before and after treatment. Uterine artery embolization group were given selective uterine artery embolization through the femoral artery agent, myoma volume changes were compared before and after the operation. The laparoscopic group used surgery to remove the fibroids. Results： The uterine and fibroid volume of drug treatment group significantly reduced after treatment; tumor volume of uterine artery embolization group were obviously reduced （success rate80%） after treatment; the laparoscopic group of uterine fibroids rate reached 98%, the bleeding was little in surgery and after operation. Conclusion： The three treatments have its advantages and disadvantages, the drug conservative treatment can be used for young women to avoid operation fertility requirements, for multiple uterine fibroids or tumor larger can use laparoscopic myomectomy.