Cheviakoff S, Bocaz J A, Martínez L, Romero C
Departamento de Obstetricia y Ginecología, Hospital José Joaquín Aguirre, Universidad de Chile.
Rev Chil Obstet Ginecol. 1994;59(6):416-20; discussion 420-1.
Six patients with symptomatic leiomyomata uteri and in whom surgical treatment was indicated received, during 3 months, intramuscular leuprolide acetate, 3,75 mg monthly, in order to 1) achieve a reduction of myomata size and 2) recover an anemic patient before surgery. In every patient, amenorrhea was induced since the second month of treatment. A significant decrease of myomas sizes was achieved. The reduction of the volume of the largest myoma in each case, varied between 51% and 77% (x = 60% +/- ES 4,3) LH and estradiol plasma levels diminished significantly and FSH did not changed in response to treatment. Side effects were well tolerated. Hot flashes were present in all patients, headaches in 2 and loss of strength in 2. Surgery was accomplished after 3 months of treatment. Myomectomy was performed in 5 cases and total hysterectomy in 1. Uterine shrinkage and the period of amenorrhea induced by Lupron-depot facilitated hysterectomy and myomectomy techniques and the recovery of one patient with a severe anemia.
六名有症状的子宫肌瘤患者,均有手术治疗指征,在3个月内每月肌肉注射3.75毫克醋酸亮丙瑞林,目的是:1)减小肌瘤大小;2)使贫血患者在手术前恢复。从治疗的第二个月起,每位患者均出现闭经。肌瘤大小显著减小。每个病例中最大肌瘤体积的缩小幅度在51%至77%之间(x = 60% +/- 标准误4.3),血浆促黄体生成素(LH)和雌二醇水平显著降低,促卵泡生成素(FSH)水平在治疗后未发生变化。副作用耐受性良好。所有患者均出现潮热,2例出现头痛,2例出现乏力。治疗3个月后进行手术。5例行肌瘤切除术,1例行全子宫切除术。长效醋酸亮丙瑞林引起的子宫缩小和闭经期,有利于子宫切除术和肌瘤切除术的操作,并使一名严重贫血患者得以康复。