腹腔镜巨大子宫肌瘤剔除术前应用米非司酮的疗效评估  

Efficacy evaluation on preoperative use of mifepristone in patients undergoing laparoscopic resection of giant hysteromyoma

作　　者：丁堪铄[1] 熊文雯 沈庆君 邓庆珊[1] Ding Kanshuo;Xiong Wenwen;Shen Qingjun;Deng Qingshan(Department of Gynecology,Guangdong Maternal and Children’s Hospital,Guangzhou 510010,Guangdong,China)

机构地区：[1]广东省妇幼保健院,广东广州510010

出　　处：《广州医科大学学报》2020年第2期56-59,共4页Academic Journal of Guangzhou Medical University

基　　金：广东省科技厅科技计划基金(2014A020212237)。

摘　　要：目的:探讨术前使用米非司酮对腹腔镜巨大子宫肌瘤剔除术的影响及疗效。方法:选择本院2018年1月至2019年6月收治的30例巨大子宫肌瘤患者为研究组,术前1个月开始口服米非司酮,25 mg每晚一次至手术前晚,同期选择40例巨大子宫肌瘤患者术前未使用任何药物为对照组,两组患者均行腹腔镜下子宫肌瘤剔除术,比较两组患者子宫及肌瘤体积、术中出血量、手术时间、术后血红蛋白下降情况、下床时间、住院时间、术后并发症及不良反应。结果:研究组患者术前1个月与术前1天的子宫体积及肌瘤体积的比较,差异均有统计学意义(P<0.05);两组患者术中出血量、手术时间、术后血红蛋白下降情况及下床时间的比较,差异均有统计学意义(P<0.05),住院时间组间比较差异无统计学意义(P>0.05)。比较两组患者术后感染、切口出血、皮下气肿、肠梗阻等并发症的发生率,研究组发生率明显下降(P<0.05)。研究组中服药出现不良反应者极少,仅2例,未影响研究及手术进程。结论:在巨大子宫肌瘤患者行腹腔镜剔除术前使用米非司酮治疗1个月,可有效缩小肌瘤体积、减少术中出血,降低术中术后并发症,达到加快患者术后恢复、减少医疗费用等价值,值得临床上推广。Objective:To investigate the value of preoperative mifepristone in patients undergoing laparoscopic resection of giant hysteromyoma.Methods:Thirty patients with giant hysteromyoma admitted to our hospital between January 2018 and June 2019 were enrolled as the study group to receive oral Mifepristone 25 mg,taken once per night until immediately prior to the day of operation.A contemporary cohort of 40 patients with giant hysteromyoma who did not receive any preoperative medication were enrolled as the control group.The both groups underwent laparoscopic resection of the hysteromyoma,and were then compared for the size of uterus and myoma,intraoperative blood loss,operation time,post-operative hemoglobin decline,time to ambulation,length of hospital stay,postoperative complications and adverse reactions.Results:In the study group,the sizes of uterine and hysteromyoma at one day prior to the operation significantly differed with those measured at one month before(P<0.05).There were significant differences in the intraoperative blood loss,operation time,postoperative hemoglobin decline and time to ambulation(P<0.05),but not in the length of hospital stay(P>0.05),between the two groups.The incidence rates of postoperative infection,incision site bleeding,subcutaneous emphysema,intestinal obstruction and other complications in the study group were significantly lower than those in the control group(P<0.05).Drug-related adverse reactions were fairly rare in the study group,as noted only in 2 cases,and did not affect the process of study and surgery.Conclusion:A one-month preoperative use of mifepristone prior to laparoscopic resection of giant hysteromyoma may lead to definite reductions on tumor size,intraoperative blood loss,intraoperative and postoperative complications,as well as quicker postoperative recovery and less medical costs.These justify its widespread use in clinical settings.

关 键 词：米非司酮 巨大子宫肌瘤 腹腔镜子宫肌瘤剔除术 术前 

分 类 号：R713.4[医药卫生—妇产科学]