卵巢巧克力囊肿术后行小剂量米非司酮预防复发的效果观察

Effect of low dose mifepristone on prevention of ovarian chocolate cyst recurrence after surgery

目的探究卵巢巧克力囊肿术后用小剂量米非司酮预防复发的随访效果观察。方法选取攀枝花中西医结合医院妇产科自2014年4月至2016年4月收治的120例卵巢巧克力囊肿患者,均给予了腹腔镜切除术治疗,术后对于该组患者采取随机数字表法分组,分为促性腺激素释放激素(Gn RHa)组、超小剂量组与小剂量组,每组各40例,Gn RHa组术后给予注射Gn RHa,超小剂量组每日给予6.25mg的米非司酮,小剂量组每日给予12.5mg的米非司酮,对比三组治疗前后子宫内膜的厚度、随访1年复发率及并发症发生率。结果三组术后用药3个月与术前相比子宫内膜厚度较厚,小剂量组分别与超小剂量组、Gn RHa相比子宫内膜厚度较厚,差异均具有统计学意义(t值分别为2.85~4.95,均P<0.05)。超小剂量组与Gn RHa组相比随访1年复发率较低(χ~2 =4.22,P<0.05),小剂量组分别与Gn RHa组、超小剂量组相比随访1年复发率较低,差异均具有统计学意义(χ~2 值分别为5.63、4.89,均P<0.05)。小剂量组分别与Gn RHa组、超小剂量组相比并发症发生率较低,差异均具有统计学意义(χ~2 值分别为5.78、5.92,均P<0.05)。结论卵巢巧克力囊肿术后行小剂量米非司酮预防复发具有较好的疗效,且无明显并发症,安全性较高。

objective To investigate the effect of low dose mifepristone on preventing ovarian chocolate cyst recurrence after operation.Methods Altogether 120 cases of ovarian chocolate cyst treated in obstetrics and gynecology department of Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine from April 2014 to April 2016 were selected. All patients were treated with laparoscopic resection,and then divided into gonadotropin-releasing hormone（ Gn RHa） group,ultra small dose group and low dose group using random number table method,with 40 cases in each group. Patients in Gn RHa group were treated with Gn RHa injection. Patients in ultra small dose group were given mifepristone at 6. 25mg/d,and patients in low-dose group were given mifepristone at 12. 5mg/d. Endometrial thickness before and after treatment,recurrence rate in one year follow-up and complication rate were compared among three groups.Results Endometrial thickness in 3 months of medication after surgery was thicker than that before surgery in three groups, and endometrium in low dose group was thicker than that in ultra small dose group and Gn RHa group,and difference was statistically significant（t value ranged 2. 85-4. 95,all P〈 0. 05）. Recurrence rate during one year follow-up in ultra small dose group was lower than that in Gn RHa group and recurrence rate in low dose group was lower than that in both ultra small group and Gn RHa group with statistical significant difference（ χ~2 = 6. 45,P〈 0. 05）. Complication rate in low dose group was lower than that in Gn RHa group and ultra small dose group with statistically significant difference（ χ2 = 6. 23,P〈 0. 05）. Conclusion Curative effect of low dose mifepristone is good in preventing recurrence of ovarian chocolate cyst after surgery,and it has no obvious complications and high security.