宫腔镜电切联合米非司酮治疗内突壁间肌瘤的效果观察

Observation on effect of TCRM and mifepriston combining treatment in submucous myoma Ⅱ

目的观察宫腔镜子宫肌瘤电切术(transcarvicalresectionofmyoma,TCRM)后口服米非司酮治疗子宫残余肌瘤的临床效果。方法对156例子宫肌壁间内突肌瘤及Ⅱ型黏膜下肌瘤的患者行TCRM术,其中62例有残余肌瘤的患者术毕B超测量残余肌瘤体积并随机分为研究组32例,给米非司酮口服,剂量为12.5mg,每日1次,连续口服3个月;对照组30例,术后无治疗,两组随访时间为18个月。结果肌瘤残余率≤20%,两组均自然消融吸收(P>0.05),肌瘤残余率>20%,经非条件logistic统计分析,联合米非司酮治疗可降低术后复发率,TCRM术后残留率越低复发率越低。结论宫腔镜电切术治疗壁间内突肌瘤及Ⅱ型黏膜下肌瘤,肌瘤残余率>20%以上的患者术后给予米非司酮治疗,可明显提高疗效,降低残瘤复发率。

[Objective] To study the effect of TCRM and Mireprinston combining treatment in Submucous Myoma Ⅱ, comparing with TCRM only, [Methods] 62 cases of Submucous Myoma were randomly divided into two groups.32 cases in study group were treated by TCRM combining with Mifeprinston, which was given by 12.5mg/day 3 months, and other 30 cases in control group were treated only by TCRM. The residual myoma in all cases was tested after TCRM. In the following 18 months. We observed change of the size in both group. Those whose size were larger were considered as recrudesced, or as stillness, which means the treatment on it was effective. [Results] For those whose residual size less than 20%, no significant difference in recrudescing rate between two groups, while as for 20～40%, the combining treatment was more effective than TCRM only. [Conclusions] It is significant to reduce recrudescing rate by given Mifepriston after TCRM, if the residual myoma is between 20% and 40% in Submucous Myoma Ⅱ.