米非司酮在子宫黏膜下肌瘤宫腔镜术前的应用价值

Value of the Mifepristone before hysteroscopic surgery for hysteromyoma.

目的:研究米非司酮(Ru486)在子宫黏膜下肌瘤官腔镜术前的应用价值。方法:67例患者分两组,Ⅰ组31例服用Ru486 3个月后实施经官颈子宫肌瘤切除术(TCRM),Ⅱ组36例直接行TCRM治疗。观察Ⅰ组Ru486治疗后不同时间肌瘤大小及血红蛋白变化;两组手术时间及术中出血量比较;子宫肌瘤大小与手术时间、术中出血量的相关性。结果:Ⅰ组治疗后1个月肌瘤较治疗前无明显缩小,治疗后两个月及3个月与治疗前比较肌瘤明显缩小,差异显著,P<0．01;治疗后血红蛋白增高明显,P<0．01;两组间手术时间、术中出血量比较差异显著,P<0．05;子宫肌瘤大小与手术时间及术中出血量均呈正相关。结论:Ru486作为TCRM术前的药物治疗可有效地缩小子宫肌瘤,相对扩大手术适应证,减少术中出血量,缩短手术时间;Ru486导致药物性闭经,有利于术前纠正贫血。

Objective：To study the value of the Mifepristone（Ru486）before hysteroscopic surgery for hysteromyoma. Methods： 67 patients were divided into two groups, 31 patients as study group was treated with Ru486 for 3 months before transcervical resection of myoma（TCRM）, 36 patients as control group was treated with TCRM. Results： In study group,the hysteromyoma didn＇t significantly reduce after Ru486 treatment of 1 month; The hysteromyoma had significantly reduced after Ru486 treatment of 2 -3 months, P〈0.01. Hemoglobin had significantly increased after Ru486 treatment, P〈0.01. There was significant difference in the time of surgery and the hemorrhagic volume of surgery between the two groups, P〈0.05. The size of hysteromyoma was positively related with the time of surgery and the hemorrhagic volume of surgery, Conclusions： Ru486 can reduce the size of hysteromyoma, enlarge the surgery adaptation relatively,and reduce the time of surgery and the hemorrhage of surgery. Ru486 can result in secondary amenorrhea and rectify anaemia before TCRM,