腹腔镜下卵巢囊肿切除术后配合米非司酮治疗的疗效观察25例.docVIP

腹腔镜下卵巢囊肿切除术后配合米非司酮治疗的疗效观察25例 　　doi：10.3969/j.issn.1007-614x.2014.1.44 　　摘 要 目的：评价腹腔镜手术下卵巢巧克力囊肿切除术后配合米非司酮治疗的疗效。方法：收治卵巢巧克力囊肿患者25例，给予腹腔镜囊肿剔除或者卵巢切除，术后给予米非司酮10mg，1次/日，口服3个月治疗。术后记录患者术中情况以及住院情况；随访3年，观察患者治疗效果以及复发情况。结果：所有患者均经腹腔镜完成了手术，术中出血量平均（52.5±10.2）ml；手术时间平均（64.6±7.1）分钟；术后恢复良好，无发生并发症病例，患者平均住院（6.7±5.1）天。随访3年，16例患者临床症状明显缓解；术后3个月、6个月、1年、2年、3年复发率分别0、0、4.0%、12.0%和16.0%。用药期间无严重不良反应。结论：腹腔镜下卵巢囊肿切除配合米非司酮治疗卵巢巧克力囊肿效果良好，复发率低。 　　关键词 腹腔镜 卵巢囊肿切除 米非司酮 　　Abstract Objective：To evaluate curative effect of laparoscopic ovarian chocolate cyst resection with mifepristone treatment.Methods：25 patients were admitted for diagnosis of ovarian chocolate cyst from July 2009 to July 2010，given laparoscopic cyst eliminate or ovariectomy，postoperative given mifepristone 10mg，1 time/day，oral treatment for 3 months.Postoperative record intraoperative situation and hospitalization of patients.Follow-up of 3 years，observe the curative effect and the recurrence of patients.Results：All patients were treated by laparoscopic operation，the average intraoperative blood loss was 52.5±10.2ml；the average operation time was 64.6±7.1minutes.Postoperative recovery was good，no complications occurred cases，the average patients hospitalization was 6.7±5.1days.Follow-up of 3 years，the clinical symptoms of 16 patients were obviously relieved.After 3 months，6 months，1 year，2 years，3 years recurrence rate respectively was 0%、0%、4.0%、12.0% and 16.0%.It was no serious adverse reactions during the medication.Conclusion：The curative effect of laparoscopic ovarian cyst resection with mifepristone treatment is good，the recurrence rate is low. 　　Key words Laparoscopic；Ovarian cyst resection；Mifepristone 　　卵巢囊肿是妇产科常见的疾病，可发生于任何年龄段，以30～50岁常见。该病病因尚不完全明确，一般早期无明显症状，常因体检妇科彩超发现，及早发现并采取有效措施治疗，是改善预后的关键[1]。目前，临床常用的治疗包括药物和手术治疗，但是单纯的药物治疗对卵巢囊肿尤其是激素依赖性卵巢囊肿往往无效，需行开腹或者腹腔镜手术治疗。临床实践表明开腹手术治疗卵巢囊肿易导致囊肿破裂，囊液扩散，引起腹腔黏连等问题，而腹腔镜手术则因其术中出血量少、手术时间短、疼痛轻、住院时间短、术后恢复快等优点广泛应用于临床，是目前卵巢囊肿的主要治疗方法[2]。卵巢巧克力囊肿为卵巢囊肿中较为严重的一种，是子宫内膜碎片随经血逆流经输卵管进入盆腔，种植在卵巢形成的异位囊肿，临床治疗难