GnRHa与米非司酮在腹腔镜子宫肌瘤剔除术预处理中的效果比较

摘要
图/表
参考文献(15)
相关文章 (15)

全文: PDF (0 KB) HTML (42 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探究促性腺激素释放激素类似物（GnRHa）与米非司酮在腹腔镜子宫肌瘤剔除术预处理中的效果。方法随机选取2016年1月～2018年3月在我院行腹腔镜子宫肌瘤剔除术的50 例患者作为研究对象，根据患者入院治疗单双号顺序将其分为试验组与对照组，每组各25 例。对照组患者采用GnRHa 进行预处理，试验组患者采用米非司酮进行预处理，之后两组患者均行腹腔镜子宫肌瘤剔除术治疗。观察两组患者术后子宫肌瘤复发率、子宫肌瘤组织中的雌激素受体（ER）、孕激素受体（PR）、Ki-67 蛋白阳性率、临床治疗效果、围术期指标（术中出血量、手术时间、住院时间）及用药前后子宫肌瘤直径。结果试验组患者的子宫肌瘤复发率（4.00%）低于对照组（24.00%），差异有统计学意义（P＜0.05）。试验组患者用药后的子宫肌瘤直径[（1.31±0.34）cm]小于对照组[（3.21±0.22）cm]，差异有统计学意义（P＜0.05）。试验组患者子宫肌瘤组织中的ER（64.00%）、PR（48.00%）、Ki-67 蛋白阳性率（28.00%）均分别低于对照组（88.00%、80.00%、60.00%），差异有统计学意义（P＜0.05）。试验组患者的术中出血量[（87.62±14.38）ml]少于对照组[（102.87±15.29）ml]，差异有统计学意义（P＜0.05）；试验组患者的手术时间[（56.29±5.71）min]、住院时间[（4.27±0.72）d]均短于对照组[（107.32±5.28）min、（6.21±0.11）d]，差异有统计学意义（P＜0.05）。试验组患者的临床治疗总有效率为96.00%，高于对照组的72.00%，差异有统计学意义（P＜0.05）。结论与GnRHa 比较，子宫肌瘤患者使用米非司酮有利于降低肿瘤组织中的ER、PR、Ki-67 蛋白表达水平，减少肌瘤体积，降低肌瘤复发率，其临床用药效果高于GnRHa，值得临床广泛推广应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	罗琼
	伍毓强

关键词 ：促性腺激素释放激素类似物, 米非司酮, 腹腔镜子宫肌瘤剔除术, 子宫疾病, 女性

Abstract：Objective To investigate the effect of gonadotropin releasing hormone analogue (GnRHa) and Mifepristone in the pretreatment of laparoscopic myomectomy.Methods A total of 50 patients who underwent laparoscopic myomectomy in our hospital from January 2016 to March 2018 were randomly selected as study subjects.The patients were divided into the experimental group and the control group according to order of single and double numbers of patients admitted to hospital, with 25 cases in each group.The control group was pretreated with GnRHa, while the experimental group was pretreated with Mifepristone, then patients in both groups were treated with laparoscopic myomectomy.The recurrence rate of uterine fibroids, estrogen receptor (ER), progesterone receptor (PR), Ki-67 protein positive rates,clinical treatment effect, perioperative indicators (intraoperative blood loss, operation time, hospitalization time) and diameter of uterine fibroids before and after medication were observed in the two groups.Results The recurrence rate of uterine fibroids in the experimental group (4.00%) was lower than that in the control group (24.00%), and the difference was statistically significant (P＜0.05).The diameter of uterine fibroids in the experimental group ([1.31±0.34]cm) after medication was smaller than that in the control group ([3.21±0.22]cm), with statistically significant difference (P＜0.05).The protein positive rates of ER (64.00%), PR (48.00%), and Ki-67 (28.00%) in the uterine fibroids of the experimental group were respectively lower than those of the control group (88.00%, 80.00%, and 60.00%), with statistically significant differences (P＜0.05).The intraoperative blood loss in the experimental group ([87.62±14.38]ml) was less than that in the control group ([102.87±15.29]ml), with statistically significant difference (P＜0.05).The operation time([56.29±5.71]min) and hospitalization time ([4.27±0.72]d) of the experimental group were shorter than those of the control group ([107.32±5.28]min, [6.21±0.11]d), with statistically significant differences (P＜0.05).The total effective rate of clinical treatment of patients in the experimental group was 96.00%, which was higher than that in the control group accounting for 72.00%, and the difference was statistically significant (P＜0.05).Conclusion Compared with Gn-RHa, the use of Mifepristone in patients with uterine fibroids is beneficial to reduce the expression levels of ER, PR and Ki-67 proteins in tumor tissues, reduce the volume of fibroids and reduce the recurrence rate of fibroids.The clinical effect of Mifepristone is higher than that of GnRHa, which is worthy of wide clinical promotion and application.

Key words： Gonadotropin releasing hormone analogue Mifepristone Laparoscopic myomectomy Uterine Diseases;Female

引用本文:

罗琼; 伍毓强. GnRHa与米非司酮在腹腔镜子宫肌瘤剔除术预处理中的效果比较[J]. 中国当代医药, 2020, 27(3): 53-57.
LUO Qiong; WU Yu-qiang. Effect comparison of GnRHa and Mifepristone in the pretreatment of laparoscopic myomectomy. 中国当代医药, 2020, 27(3): 53-57.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I3/53

[1]	凌静，潘晓华，谢学新，等.腹腔镜下子宫肌瘤剔除术后应用桂枝茯苓胶囊的临床研究[J].中国实用医药，2018，13（25）：118-119.
[2]	林启玉.米非司酮与腹腔镜子宫肌瘤剔除术治疗子宫肌瘤的临床效果比较[J].中国当代医药，2018，25（19）：107-109.
[3]	祁芳.实施腹腔镜子宫肌瘤剔除术前用米非司酮进行预处理的临床效果探析[J].当代医药论丛，2018，16（1）：116-117.
[4]	刘燕美.米非司酮预处理在腹腔镜子宫肌瘤剔除术中的应用价值[J].深圳中西医结合杂志，2016，26（17）：68-69.
[5]	张春妮，莫锐婷.GnRHa 用于大黏膜下子宫肌瘤宫腔镜手术前临床观察[J].深圳中西医结合杂志，2017，27（17）：174-175.
[6]	时欣欣.腹腔镜子宫肌瘤剔除术前米非司酮预处理的临床效果观察[J].河南医学研究，2016，25（3）：552-553.
[7]	张翼海.GnRHa 与米非司酮在腹腔镜子宫肌瘤剔除术预处理中效果对比[J].中国冶金工业医学杂志，2016，33（1）：33.
[8]	胡惠英.腹腔镜子宫肌瘤剔除术前米非司酮预处理的临床效果观察[J].实用药物与临床，2014，17（3）：381-383.
[9]	李晶，陈晓娟，孙华盛.米非司酮预处理对腹腔镜下子宫肌瘤剥除术患者ER、PR 及Ki-67 原位表达及肌瘤复发率的影响[J].医学临床研究，2017，34（5）：946-949.
[10]	刘鹏威.小剂量与大剂量米非司酮治疗子宫肌瘤的疗效与不良反应对比分析[J].实用妇科内分泌杂志（电子版），2017，4（15）：23，25.
[11]	刘燕美.米非司酮预处理在腹腔镜子宫肌瘤剔除术中的应用价值[J].深圳中西医结合杂志，2016，26（17）：68-69.
[12]	胡晓东.卡孕栓与米非司酮在腹腔镜下子宫肌瘤切除术中的应用效果对比[J].临床合理用药杂志，2016，9（18）：114-116.
[13]	陈华萍，郭芸.腹腔镜子宫肌瘤剔除术前米非司酮预处理的临床效果观察[J].临床误诊误治，2012，25（3）：50-52.
[14]	蒋玮琳.GnRHa 用于子宫肌瘤腹腔镜手术前治疗效果的前瞻性分析[J].深圳中西医结合杂志，2016，26（11）：138-139.
[14]	林淑玲.GnRHa 预治疗时间对腹腔镜下子宫肌瘤剔除术的影响[J].临床医学工程，2013，20（12）：1502-1504.
[15]	丛文波，姜建国.GnRHa 用于大子宫子宫肌瘤腹腔镜手术前治疗疗效的前瞻性研究[J].实用妇科内分泌杂志（电子版），2017，4（15）：3-4.