子宮肌瘤患者腹腔鏡術(shù)前應(yīng)用小劑量米非司酮對子宮動脈血流及卵巢儲備功能的影響

【摘要】 目的：探討子宮肌瘤患者腹腔鏡術(shù)前應(yīng)用小劑量米非司酮對子宮動脈血流及卵巢儲備功能的影響。方法：回顧性收集2020年1月—2022年6月豐城市婦幼保健院收治的40例接受腹腔鏡手術(shù)治療的子宮肌瘤患者的臨床資料，納入手術(shù)組；另收集本院同期收治的40例接受術(shù)前小劑量米非司酮聯(lián)合腹腔鏡手術(shù)治療的子宮肌瘤患者臨床資料，納入聯(lián)合組，所有患者且均完成術(shù)后6個月的隨訪。對比兩組子宮肌瘤大小、手術(shù)及住院情況、子宮動脈血流及卵巢儲備功能。結(jié)果：手術(shù)時，聯(lián)合組最大子宮肌瘤直徑明顯短于手術(shù)組（Plt;0.05）。聯(lián)合組手術(shù)時間短于手術(shù)組，術(shù)中出血量少于手術(shù)組（Plt;0.05）。手術(shù)時，聯(lián)合組子宮動脈血流阻力指數(shù)（RI）、搏動指數(shù)（PI）均高于治療前，且聯(lián)合組均高于手術(shù)組（Plt;0.05）。術(shù)后6個月，聯(lián)合組卵泡刺激素（FSH）水平低于手術(shù)組，雌二醇（E2）、抗穆勒氏管激素（AMH）水平均高于手術(shù)組（Plt;0.05）。結(jié)論：子宮肌瘤患者腹腔鏡術(shù)前應(yīng)用小劑量米非司酮治療可縮小子宮肌瘤，縮短手術(shù)時間，減少術(shù)中出血量，改善子宮動脈血流，在一定程度上保護患者術(shù)后卵巢儲備功能。

【關(guān)鍵詞】 子宮肌瘤 米非司酮 子宮動脈血流 卵巢儲備

Effect of Low Dose Mifepristone on Uterine Artery Blood Flow and Ovarian Reserve Function in Patients with Hysteromyoma before Laparoscopic Surgery/LI Yi. //Medical Innovation of China， 2023， 20（31）： 0-046

[Abstract] Objective： To investigate the effect of low dose Mifepristone on uterine artery blood flow and ovarian reserve function in patients with hysteromyoma before laparoscopic surgery. Method： The clinical data of 40 patients with hysteromyoma treated by laparoscopic surgery admitted to Fengcheng Maternal and Child Health Hospital from January 2020 to June 2022 were retrospectively collected， and were included in the operation group; in addition， the clinical data of 40 patients with hysteromyoma who received preoperative low-dose Mifepristone combined with laparoscopic surgery in the same period admitted to our hospital were collected and included in the combined group， and all patients were completed a follow-up for 6 months after surgery. The size of hysteromyoma， operation and hospitalization conditions， uterine artery blood flow and ovarian reserve function were compared between the two groups. Result： At the time of operation， the diameter of the largest hysteromyoma in the combined group was significantly shorter than that in the operation group （Plt;0.05）. The operation time of the combined group was shorter than that of the operation group， and the intraoperative bleeding loss volume was less than that of the operation group （Plt;0.05）. At the time of operation， the uterine artery blood flow resistance index （RI） and pulsation index （PI） in the combined group were higher than those before treatment， and those in the combined group were higher than those in the operation group （Plt;0.05）. At 6 months after operation， the follicle stimulating hormone （FSH） level in the combined group was lower than that in the operation group， and the estradiol （E2） and anti-mullerian hormone （AMH） levels were higher than those in the operation group （Plt;0.05）. Conclusion： The application of low dose Mifepristone before laparoscopic surgery in patients with hysteromyoma can reduce the size of hysteromyoma， shorten the operation time， reduce intraoperative bleeding， improve uterine artery blood flow， and protect the ovarian reserve function of patients after surgery to a certain extent.

[Key words] Hysteromyoma Mifepristone Uterine artery blood flow Ovarian reserve

First-author's address： Fengcheng Maternal and Child Health Hospital， Jiangxi Province， Fengcheng 331100， China

doi：10.3969/j.issn.1674-4985.2023.31.010

子宮肌瘤患者初期可無自覺癥狀，隨著瘤體增大、數(shù)量增多，可引起月經(jīng)異常、下腹墜脹等，對女性身心健康造成不利影響[1]。腹腔鏡手術(shù)是目前臨床治療子宮肌瘤直接、有效的方式，手術(shù)醫(yī)師可在直視下精準切除病灶，達到治療的目的，但部分患者子宮肌瘤較大，會增加手術(shù)難度[2]。……