CAJ | 학술논문

目的：探究手术前后小剂量应用米非司酮对子宫肌瘤手术的效果影响。方法选取2011年1月至2013年1月来本院就诊的行手术治疗子宫肌瘤患者180例，依据分层随机分组法将患者分为治疗组、对照组和空白组，每组60例。对照组在术前100 d开始小剂量服用米非司酮直至手术时和术后停止；治疗组在对照组的基础上术后小剂量服用米非司酮6个月；空白组患者仅给予安慰剂处理，处理结束后给予常规手术治疗。结果患者初诊时子宫肌瘤大小、孕酮及雌激素水平比较差异无统计学意义（P＞0．05）；用药后，治疗组及对照组患者术前的子宫肌瘤及孕酮明显小于空白组，差异有统计学意义（P＜0．05）；治疗组及对照组患者的术中出血量、阴道流血时间、手术时间、术后出现发热例数、术后疼痛时间及住院时间明显低于空白组，差异有统计学意义（P＜0．05）。治疗组及对照组肿瘤组织中孕激素受体水平（PR）、表皮生长因子受体（EGFR）水平均低于空白组，差异有统计学意义（P＜0．05）；术后治疗组患者月经恢复时间明显高于对照组及空白组，差异有统计学意义（P＜0．05）；术后6个月治疗组患者孕酮水平明显低于对照组及空白组，差异有统计学意义（ P＜0．05）；术后6个月及12个月后治疗组患者的子宫肌瘤复发例数明显低于对照组及空白组（P＜0．05）。结论术前小剂量应用米非司酮可显著抑制肿瘤的发展、缩小子宫肌瘤大小、降低术中出血、促进术后恢复，术后使用小剂量的米非司酮可明显降低患者术后复发率。
목적：탐구수술전후소제량응용미비사동대자궁기류수술적효과영향。방법선취2011년1월지2013년1월래본원취진적행수술치료자궁기류환자180례，의거분층수궤분조법장환자분위치료조、대조조화공백조，매조60례。대조조재술전100 d개시소제량복용미비사동직지수술시화술후정지；치료조재대조조적기출상술후소제량복용미비사동6개월；공백조환자부급여안위제처리，처리결속후급여상규수술치료。결과환자초진시자궁기류대소、잉동급자격소수평비교차이무통계학의의（P＞0．05）；용약후，치료조급대조조환자술전적자궁기류급잉동명현소우공백조，차이유통계학의의（P＜0．05）；치료조급대조조환자적술중출혈량、음도류혈시간、수술시간、술후출현발열례수、술후동통시간급주원시간명현저우공백조，차이유통계학의의（P＜0．05）。치료조급대조조종류조직중잉격소수체수평（PR）、표피생장인자수체（EGFR）수평균저우공백조，차이유통계학의의（P＜0．05）；술후치료조환자월경회복시간명현고우대조조급공백조，차이유통계학의의（P＜0．05）；술후6개월치료조환자잉동수평명현저우대조조급공백조，차이유통계학의의（ P＜0．05）；술후6개월급12개월후치료조환자적자궁기류복발례수명현저우대조조급공백조（P＜0．05）。결론술전소제량응용미비사동가현저억제종류적발전、축소자궁기류대소、강저술중출혈、촉진술후회복，술후사용소제량적미비사동가명현강저환자술후복발솔。
Objective To explore The effects of the results of surgery for patients with uterine fibroids taking small doses of Mifepristone before and after surgery .Methods 180 cases of uterine fibroids patients were selected which come to our hospital from January 2011 to January 2013 for treatment .The patients were divided into treat-ment group ,control group and blank group according to the stratified randomization method .There were 60 cases of patients in each group .The control group accepted the small doses of mifepristone for 100 days until surgery and the treatment group accepted small doses of mifepristone for 6 months after surgery .The blank group accepted placebo from 100 days before until 6 months after surgery .Then all of the patients accepted operation for treatment .Results There was no statistically significant difference of the size of uterine fibroids ,progesterone and estrogen level of the both groups at the first time for treatment (P> 0 .05) .The size of uterine fibroids and progesterone of treatment group and control group were significantly less than the blank group in the preoperative (P <0 .05 ) .The blood loss during the operation ,the numbers of days vaginal bleeding ,operative time ,the number of cases of postoperative fe-ver ,the days of the postoperative pain and the days of hospitalization of the treatment group and control group were all significantly lower than the blank group (P< 0 .05) .The levels of tumor tissue levels of progesterone receptor (PR) and epidermal growth factor receptor(EGFR) of the treatment group and control group were still lower than the blank group(P<0 .05) .The menstruation returned days after the surgery of the treatment group were signifi-cantly higher than the control group and the blank group (P<0 .05);.The progesterone levels of the treatment group was significantly lower than the control group and blank group six months after of treatment (P<0 .05);The recur-rence of the treatment group was significantly lower than the control group and blank group 6 months and 12 months after operation(P< 0 .05) .Conclusion Preoperative low-dose mifepristone significantly inhibited tumor develop-ment ,the size of uterine fibroids ,reduce blood loss ,and promote postoperative recovery ,postoperative use of small doses of mifepristone can significantly reduce the recurrence rate in patients .