摘要
目的:探讨米非司酮和GnRH-a用于盆腔子宫内膜异位症术后辅助治疗的疗效及安全性。方法:选择2007年4月至2008年3月我院进行腹腔镜或开腹手术并经病理证实为盆腔子宫内异症(包括卵巢巧克力囊肿)的患者150例,其中术后应用米非司酮60例(米非司酮组),术后开始口服米非司酮10mg/d,共3个月。GnRH-a组52例(GnRH-a组),术后第一次月经来潮1-5天内,皮下注射诺雷德3.6mg,28天1次,共3次;术后未用药38例(未用药组),术后未用药物仅定期随访。比较150例盆腔子宫内膜异位症术后应用米非司酮、GnRH-a及未用药组的复发率、妊娠情况和不良反应发生率。结果:米非司酮组及GnRH-a组患者疼痛症状和体征完全缓解率分别为65.0%及71.4%,显著高于对照组的52.6%,差异有统计学意义(P<0.05),米非司酮组及GnRH-a组患者复发率分别为5.0%及3.8%,显著低于对照组的21.1%(P<0.05),而米非司酮组与GnRH-a组比较,差异无统计学意义(P>0.05)米非司酮组不良反应发生率25.0%,显著低于GnRH-a组57.6%(P<0.05)。结论:GnRH-a、米非司酮用于盆腔子宫内膜异位症的术后辅助治疗有效,与未用药组相比复发率低,米非司酮组较GnRH-a组副反应少。
Objective :To evaluate the efficacy and side effects of mifepristone and GnRH-a on endometriotic patients after conservative surgery. Methods:one hungerd and fifty women with moderate or severe endometriosis after conservative surgery were divided into three groups: mifepristone group (60 cases,mifepristone 10mg/d, 3 months) ; gonadotrop in releasing hormone agonist (GnRH- a) group (52 cases, hypodermically leuprorelin acetate 3.60 mg, once per twenty - eight days for 3 months) ; control group (38 cases) did not receive any postoperative medical treatment. Recurrence rate and adverse effect rate were compared among these groups. Side-effects were recorded after treatment. Results:Pelvic pain and uterine cramping of all patients were relieved; both mifepristone group and GnRH-a treatment group achieved significant relief of pelvic symptoms and signs (65.0% and 71.0% ) than that(52.6%) of the control group ( P < 0105). there were no significant differences between mifepristone group and GnRH-a group (P>0105).The recurrence rates of mifepristone group and GnRH-a group were5.0% and 3.8% ,respectively,significantly lower than that(21.1%) of control group (P < 0. 05,). The adverse effect rate of mifepristone group was 25.0% , which was significantly lower than that of GnRH-a group (57.6%) (P < 0. 05). Conclusion:Mifepristone and GnRH-a are effective for postoperative pelvis endometriosis. Mifepristone has less adverse effects than that of GnRH- a
引文
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