摘要
目的观察不同剂量的米非司酮在预防卵巢巧克力囊肿剥除术后复发的临床效果。方法选取卵巢巧克力囊肿患者64例,腹腔镜下卵巢囊肿剥除术后随机编入3组,分别使用超小剂量米非司酮6.25mg/d（A组）、小剂量米非司酮12.5mg/d（B组）和促性腺激素释放激素类药物（达菲林）（C组）,疗程均为3个月并随访1年,观察各组复发率及不良反应情况。结果术后1年的各组复发率比较有显著性差异（χ^2=6.018,P〈0.05）,A组复发率最高（30.43%）,C组复发率最低（6.67%）。A组患者术前和术后用药第3个月子宫内膜厚度无显著性差异（t=1.263,P〉0.05）,B组患者术后用药第3个月子宫内膜厚度显著高于术前（t=3.674,P〈0.05）,C组患者术后用药第3个月子宫内膜厚度显著低于术前（t=4.257,P〈0.05）。经Fisher确切概率法检验,A组和B组患者术前和用药后子宫内膜病理分型均无显著性差异（P值分别为0.265、0.051,均P〉0.05）,C组患者术前和用药后子宫内膜病理分型有显著性差异（P=0.023〈0.05）,各组患者用药后均无子宫内膜复杂性增生发生。3组患者总不良反应发生率有显著性差异（P=0.029〈0.05）,C组最高（52.94%）。结论小剂量米非司酮可有效预防卵巢巧克力囊肿术后复发,不良反应相对较小,短期应用未发现子宫内膜异常增生,有临床应用价值。
Objective To investigate the clinical effect of different doses of mifepristone on preventing postoperative recurrence of chocolate cyst of ovary. Methods Totally 64 cases of chocolate cyst of ovary were divided into 3 groups after divest of cyst using abdominoscope.Cases in group A were given ultra-low-dose mifepristone（ 6. 25 mg / d）,cases in group B were applied with low-dose mifepristone（ 12. 5mg/d） and cases in group C were applied with GnRHa（ Diphereline）. The course was 3 months and they were followed up for 1year. Recurrence rates and adverse reactions of 3 groups were observed. Results There was significant difference in recurrence rate after 1year（ χ^2= 6. 018,P〈0. 05）. The highest recurrence rate was found in group A（ 30. 43%） and the lowest in group C（ 6. 67%）. There was no significant difference in group A in preoperative endometrial thickness compared to that 3 months after surgery（ t = 1. 263,P〈0. 05）. In group B the endometrial thickness 3 months after surgery was significantly higher than that before surgery（ t = 3. 674,P〈0. 05）,but it was significantly lower in group C（ t = 4. 257,P〈0. 05）. Fisher＇s exact probability method revealed that endometrial pathologic classification was not obviously different before surgery and after medication in both group A and group B（ P value was 0. 265 and 0. 051,respectively,both P〈0. 05）,but significant difference was found in group C（ P = 0. 023 0. 05）. No complexity of endometrial hyperplasia was found in any group. The total incidence of adverse reactions was remarkably different among 3 groups（ P =0. 029 0. 05） with highest rate in group C（ 52. 94%）. Conclusion Low-dose mifepristone could prevent postoperative recurrence of chocolate cyst of ovary effectively with mild adverse reactions and no endometrial paraplasm after short-term medication. It is valuable in clinical application.
作者
冯晓丹
李岚
郭洁
季静
徐文怡
顾丹萍
史益凭
姚敏
张保华
FENG Xiao-dan LI Lan GUO Jie JI Jing XU Wen-yi GU Dan-ping SHI Yi-ping YAO Min ZHANG Bao-hua(Department of Obstetrics and Gynecology, Punan Hospital in Pudong New Area of Shanghai, Shanghai 200123, China)
出处
《中国妇幼健康研究》
2016年第10期1261-1264,共4页
Chinese Journal of Woman and Child Health Research
基金
上海市浦东新区科技发展基金创新资金(PKJ2013-Y35)
上海市浦东新区卫生系统优秀青年医学人才培养项目(PWRq2013-18)
浦东新区卫生系统重点专科项目(PWZz2013-12)
关键词
米非司酮
卵巢巧克力囊肿
复发
子宫内膜增生
mifepristone
chocolate cyst of ovary
recurrence
endometrial hyperplasia
