腹腔镜手术配合米非司酮治疗子宫内膜异位症临床观察  

Clinical efficacy of laparoscopic surgery combined with mifepristone in the treatment of endometriosis

作　　者：张庆 王利平 要静 Zhang Qing;Wang Liping;Yao Jing(Kaifeng Hospital of Traditional Chinese Medicine,Henan475000)

机构地区：[1]河南省开封市中医院,河南475000

出　　处：《天津药学》2021年第4期43-45,共3页Tianjin Pharmacy

摘　　要：目的:探讨腹腔镜手术配合米非司酮在治疗子宫内膜异位症中的临床疗效及对复发率和受孕率的影响。方法:选取2018年5月—2020年12月本院子宫内膜异位症患者94例,按随机数字表法分为观察组与对照组各47例。对照组予以腹腔镜手术治疗,观察组在对照组的基础上于术后2 d口服米非司酮,12.5 mg/次,1次/d,连续治疗3个月。比较两组疗效、卵巢体积、窦卵泡数、血清血管内皮生长因子(VEGF)、血管内皮生长因子受体1(VEGFR1)、复发率及受孕率。结果:观察组和对照组总有效率分别为93.62%和78.72%(P<0.05)。治疗前后比较,两组卵巢体积均缩小,窦卵泡数增加(P<0.05);治疗后观察组卵巢体积较对照组小,窦卵泡数较对照组多(P<0.01)。治疗后,观察组血清VEGF、VEGFR1均较对照组低(P<0.05)。观察组和对照组复发率分别为2.17%和22.22%;受孕率分别为26.09%和6.67%(P<0.05)。结论:腹腔镜手术配合米非司酮治疗子宫内膜异位症,可提高疗效,缩小卵巢体积,增多窦卵泡数,调节VEGF、VEGFR1表达,抑制微血管增多,预防内膜再种植,避免复发,提高受孕率。Objective:To investigate the clinical efficacy of laparoscopic surgery combined with mifepristone in treating endometriosis and its effect on recurrence rate and pregnancy rate.Methods:94 patients with endometriosis admitted to our hospital from May 2018 to December 2020 were randomly divided into the observation group(n=47)and the control group(n=47).The control group was treated with laparoscopic surgery,and the observation group was treated with mifepristone(12.5 mg/time,once a day,for three months)on the basis of the control group.The efficacy,ovarian volume,number of follicles in the follicular sinus,serum vascular endothelial growth factor(VEGF),vascular endothelial growth factor receptor 1(VEGFR1),recurrence rate,and pregnancy rate were compared between the two groups.Results:The total effective rate of the observation group and the control group were 93.62%(44/47)and 78.72%(37/47),respectively(P<0.05).Compared with before and after treatment,the ovary volume decreased and the number of follicles in the follicular sinus increased in both groups(P<0.05).After treatment,the volume of ovary in the observation group was smaller,and the number of follicles in the follicular sinus was more than that in the control group(P<0.01).In addition,serum VEGF and VEGFR1 in the observation group were lower than those in the control group after treatment(P<0.05).The recurrence rates of the observation group and the control group were 2.17%(1/46)and 22.22%(10/45),respectively,and the conception rates were 26.09%(12/46)and 6.67%(3/45),respectively(P<0.05).Conclusion:Laparoscopic surgery combined with mifepristone in the treatment of endometriosis can improve the curative effect,reduce the volume of the ovary,increase the number of follicles in the follicular sinus,regulate the expression of VEGF and VEGFR1,inhibit the increase of microvessels,prevent endometrial replanting,avoid recurrence,and increase pregnancy rate.

关 键 词：子宫内膜异位症 腹腔镜手术 米非司酮 受孕率 复发率 

分 类 号：R711[医药卫生—妇产科学]