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| 米非司酮 孕三烯酮 醋酸亮丙瑞林治疗子宫肌瘤腹腔镜切除术后患者的疗效比较 |
| Efficacy of mifepristone, gestoenone and leuprolide acetate in patients afterlaparoscopic hysteromyoma resection |
| 投稿时间：2020-05-27 |
| DOI：10.3969/j.issn.1000-0399.2020.11.012 |
| 中文关键词: 米非司酮 孕三烯酮 醋酸亮丙瑞林 子宫肌瘤 腹腔镜 |
| 英文关键词: Mifepristone Gestoenone Leuprolide acetate Hysteromyoma Laparoscope |
| 基金项目:上海市浦东新区卫生和计划生育委员会青年科技项目(项目编号:PW2017B-18),上海市卫生健康委员会卫生行业临床研究专项计 划(项目编号:201940222) |
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| 中文摘要: |
| 目的 比较米非司酮、孕三烯酮、醋酸亮丙瑞林治疗子宫肌瘤腹腔镜切除术后患者的临床疗效。方法 选取2017年11月至2019年6月在上海市周浦医院行腹腔镜子宫肌瘤切除患者132例,根据药物治疗选择,分为对照组(未服用激素类药物,n=40)、孕三烯酮组(服用孕三烯酮,n=24)、米非司酮组(服用米非司酮,n=36)和醋酸亮丙瑞林组(注射醋酸亮丙瑞林,n=32),并于术后监测预后指标,进行统计学分析。结果 随访第12个月,米非司酮组和醋酸亮丙瑞林组分别出现肌瘤复发3例、1例,复发率低于对照组(P<0.05)。随访期间,治疗组3组患者子宫体积、促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、血红蛋白水平差异有统计学意义(P<0.05),其中子宫体积、FSH、LH、E2随时间的推移呈下降趋势(P<0.05),血红蛋白呈上升趋势(P<0.05),随访第12个月,醋酸亮丙瑞林组患者子宫体积、FSH、LH、E2小于孕三烯酮组和米非司酮组(P<0.05),血红蛋白高于孕三烯酮组和米非司酮组(P<0.05)。结论 米非司酮、醋酸亮丙瑞林药物对预防子宫肌瘤腹腔镜切除术后患者的肿瘤复发均有显著的效果,醋酸亮丙瑞林的治疗效果更佳。 |
| 英文摘要: |
| Objective To evaluate the efficacy of mifepristone, progesterone and leprorelin acetate in the treatment of patients with hysteromyoma after laparoscopic hysteromyoma resection. Methods From November 2017 to June 2019, 132 cases of patients who received laparoscopic myomectomy in Shanghai Zhoupu Hospital were selected and divided based on drug choice into control group(no hormone drugs, n=40), progesterone group(taking progesterone, n=24), mifepristone group(taking mifepristone, n=36) and leproprofen acetate group(taking leproprofen acetate, n=32). The prognosis indexes were monitored and compared statistically after operation. Results Up to 12 months' follow-up, 3 cases and 1 case of myoma recurred in mifepristone group and leproprofen acetate group, respectively, of which the 龙晓林, 黄玉玲, 孙筱放, 等. 冻融液的温度对人卵玻璃化冻融效果的影 响. 实用妇产科杂志, 2009, 25(10):603-605. 饶金鹏, 邱枫, 金敏. 解冻液I温度设定对小鼠卵母细胞玻璃化冻融效果的影响. 浙江中西医结合杂志, 2016, 26(9):811-813. SCIORIO R, THONG K J, PICKERING S J. Single blastocyst transfer (SET) and pregnancy outcome of day 5 and day 6 human blastocysts vitrified using a closed device. Cryobiology, 2018, 84:40-45. BOURDON M, POCATE-CHERIET K, FINET DE BANTEL A, et al. Day 5 versus Day 6 blastocyst transfers:a systematic review and meta-analysis of clinical outcomes. Hum Reprod, 2019, 34(10):1948-1964. ZHANG H, ARHIN SK, ZHAO J, et al. Delayed development influences the outcome of different grades of D5 and D6 blastocysts during freeze-thaw cycle. Cell Mol Biol (Noisy-le-grand), 2019, 65(4):1-5. 何丽娟, 毕世杰, 蒋庆峰. 不同发育天数冻融囊胚移植的临床结局比较. 中外医疗, 2019, 38(5):62-64. (2020-03-23收稿)(本文编校:胡欣, 刘菲) recurrence rate was lower than that in control group(P<0.05). During follow-up, there were significant differences in comparison of uterine volume, FSH, LH, E2 and hemoglobin level among three treatment groups(P<0.05). The uterine volume, FSH, LH and E2 had a decreased trend over time, whereas the hemoglobin presented an increased trend(P<0.05). Up to 12 months'follow-up, uterine volume, FSH, LH and E2 of leproprofen acetate group were lower than those in progesterone and mifepristone group(P<0.05), whereas the hemoglobin level was higher than that in these two groups(P<0.05). Conclusions The mifepristone and leproprofen acetate drugs have significant effect on preventing tumor recurrence in patients with hysteromyoma after laparoscopic resection, and the treatment effect of lebuprofen acetate is estimated to be better. |
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