Yu Yan-hong, Gong Shi-peng, Wan Shu-mei
Department of Obstetrics and Gynecology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Di Yi Jun Yi Da Xue Xue Bao. 2004 Mar;24(3):317-9.
To study the clinical application of GnRHa prior to uterine myomectomy and its effect on the clinical outcome of pregnancy.
A retrospective review of the medical records in 20 cases of uterine myomectomy over a period of 6 years was performed. The changes of uterus and myoma volumes in response to preoperative GnRHa was observed, and the rate of relapse in the follow-up, time of impregnation, spontaneous abortion after the impregnation, time of delivery after the operation and the aura threatening uterine rupture, and uterine rupture during the delivery were assessed.
Application of GnRHa produced significant improvement in the clinical symptoms and resulted in obviously reduced volumes of the uterus and myoma. The myoma volume reduction was close to 50% in these cases, and relapse occurred in only 1 case. No spontaneous abortion was found after GnRHa application. The average time of pregnancy was 34+/-3.5 weeks, and aura for uterine rupture was found in 1 case at 33 weeks of pregnancy after GnRHa application.
Application of GnRHa can correct anemia, decrease the relapse rate of myoma, reduce uterus and myoma volumes, to make possible smaller incision for uterine myomectomy that leaves smaller scar in the uterus and decrease intraoperative bleeding, also relieving endometrial injuries to promote the conditions for impregnation and minimize the risks of uterine rupture and total hysterectomy for the benefit of normal delivery.
研究促性腺激素释放激素激动剂（GnRHa）在子宫肌瘤切除术术前的临床应用及其对妊娠临床结局的影响。
回顾性分析6年间20例行子宫肌瘤切除术患者的病历资料。观察术前应用GnRHa后子宫及肌瘤体积的变化，并评估随访中的复发率、受孕时间、受孕后的自然流产情况、术后分娩时间以及分娩时子宫破裂先兆和子宫破裂情况。
应用GnRHa后临床症状有显著改善，子宫和肌瘤体积明显缩小。这些病例中肌瘤体积缩小近50%，仅1例复发。应用GnRHa后未发现自然流产情况。平均妊娠时间为34±3.5周，应用GnRHa后1例在妊娠33周时出现子宫破裂先兆。
应用GnRHa可纠正贫血，降低肌瘤复发率，缩小子宫和肌瘤体积，使子宫肌瘤切除术切口更小，子宫瘢痕更小，减少术中出血，减轻子宫内膜损伤，改善受孕条件，降低子宫破裂和全子宫切除的风险，有利于正常分娩。
