Vercellini P, Bocciolone L, Colombo A, Vendola N, Meschia M, Bolis G
L. Mangiagalli Department of Obstetrics and Gynecology, University of Milano School of Medicine, Italy.
Acta Obstet Gynecol Scand. 1993 Jul;72(5):369-73. doi: 10.3109/00016349309021115.
To investigate the effect of gonadotropin releasing hormone agonist (goserelin) treatment before hysterectomy for leiomyomata-associated menorrhagia.
Prospective, comparative, nonrandomized study.
A teaching hospital of Milano University.
Anemic women requiring hysterectomy for myoma-associated menorrhagia.
Six months' preoperative goserelin treatment (41 cases) or immediate surgery (92 controls).
Abdominal/vaginal hysterectomy rate, number of transfusions, operating time, blood loss, complications, febrile morbidity, and days in hospital.
In the goserelin group mean hemoglobin rose (8.5 versus 13.3 g/dl) and mean uterine volume decreased (528 versus 251 ml). At preoperative pelvic exploration abdominal hysterectomy was indicated in 22 (54%) cases and 74 (80%) controls and vaginal hysterectomy in 19 (46%) and 18 (20%) (relative risk 3.6, 95% confidence interval 1.6 to 7.7; p = 0.001). No case required a transfusion whereas 51% of controls needed a total of 127 packed red cell units.
In anemic women with menorrhagia and leiomyomas, gonadotropin releasing hormone agonist treatment before hysterectomy limited transfusion requirements and increased the vaginal procedure rate.
探讨促性腺激素释放激素激动剂（戈舍瑞林）在子宫肌瘤相关性月经过多患者子宫切除术前治疗的效果。
前瞻性、比较性、非随机研究。
米兰大学的一所教学医院。
因肌瘤相关性月经过多需要子宫切除术的贫血女性。
术前戈舍瑞林治疗6个月（41例）或立即手术（92例对照）。
腹式/阴式子宫切除率、输血次数、手术时间、失血量、并发症、发热发病率及住院天数。
戈舍瑞林组平均血红蛋白升高（8.5对13.3g/dl），平均子宫体积减小（528对251ml）。术前盆腔探查时，22例（54%）戈舍瑞林组患者和74例（80%）对照组患者需行腹式子宫切除术，19例（46%）戈舍瑞林组患者和18例（20%）对照组患者需行阴式子宫切除术（相对危险度3.6，9 5%置信区间1.6至7.7；p = 0.001）。戈舍瑞林组无患者需要输血，而51%的对照组患者共需要127单位浓缩红细胞。
在患有月经过多和子宫肌瘤的贫血女性中，子宫切除术前使用促性腺激素释放激素激动剂治疗可减少输血需求并提高阴式手术率。
