子宫肌瘤患者腹腔镜术前应用小剂量米非司酮对子宫动脉血流及卵巢储备功能的影响

Effect of Low Dose Mifepristone on Uterine Artery Blood Flow and Ovarian Reserve Function in Patients with Hysteromyoma before Laparoscopic Surgery

目的:探讨子宫肌瘤患者腹腔镜术前应用小剂量米非司酮对子宫动脉血流及卵巢储备功能的影响。方法:回顾性收集2020年1月—2022年6月丰城市妇幼保健院收治的40例接受腹腔镜手术治疗的子宫肌瘤患者的临床资料,纳入手术组;另收集本院同期收治的40例接受术前小剂量米非司酮联合腹腔镜手术治疗的子宫肌瘤患者临床资料,纳入联合组,所有患者且均完成术后6个月的随访。对比两组子宫肌瘤大小、手术及住院情况、子宫动脉血流及卵巢储备功能。结果:手术时,联合组最大子宫肌瘤直径明显短于手术组(P<0.05)。联合组手术时间短于手术组,术中出血量少于手术组(P<0.05)。手术时,联合组子宫动脉血流阻力指数(RI)、搏动指数(PI)均高于治疗前,且联合组均高于手术组(P<0.05)。术后6个月,联合组卵泡刺激素(FSH)水平低于手术组,雌二醇(E2)、抗穆勒氏管激素(AMH)水平均高于手术组(P<0.05)。结论:子宫肌瘤患者腹腔镜术前应用小剂量米非司酮治疗可缩小子宫肌瘤,缩短手术时间,减少术中出血量,改善子宫动脉血流,在一定程度上保护患者术后卵巢储备功能。

Objective:To investigate the effect of low dose Mifepristone on uterine artery blood flow and ovarian reserve function in patients with hysteromyoma before laparoscopic surgery.Method:The clinical data of 40 patients with hysteromyoma treated by laparoscopic surgery admitted to Fengcheng Maternal and Child Health Hospital from January 2020 to June 2022 were retrospectively collected,and were included in the operation group;in addition,the clinical data of 40 patients with hysteromyoma who received preoperative low-dose Mifepristone combined with laparoscopic surgery in the same period admitted to our hospital were collected and included in the combined group,and all patients were completed a follow-up for 6 months after surgery.The size of hysteromyoma,operation and hospitalization conditions,uterine artery blood flow and ovarian reserve function were compared between the two groups.Result:At the time of operation,the diameter of the largest hysteromyoma in the combined group was significantly shorter than that in the operation group(P<0.05).The operation time of the combined group was shorter than that of the operation group,and the intraoperative bleeding loss volume was less than that of the operation group(P<0.05).At the time of operation,the uterine artery blood flow resistance index(RI)and pulsation index(PI)in the combined group were higher than those before treatment,and those in the combined group were higher than those in the operation group(P<0.05).At 6 months after operation,the follicle stimulating hormone(FSH)level in the combined group was lower than that in the operation group,and the estradiol(E2)and anti-mullerian hormone(AMH)levels were higher than those in the operation group(P<0.05).Conclusion:The application of low dose Mifepristone before laparoscopic surgery in patients with hysteromyoma can reduce the size of hysteromyoma,shorten the operation time,reduce intraoperative bleeding,improve uterine artery blood flow,and protect the ovarian reserve function of patients after surgery to a certain extent.