GnRH-a在子宫肌瘤治疗中的应用分析

Application Analysis of GnRH-a in the Treatment of Uterine Fibroids

子宫肌瘤是临床上最常见的女性生殖系统良性肿瘤,可引起异常子宫出血、压迫症状、腹痛和不孕等,目前药物治疗效果有限,主要以手术治疗为主。促性腺激素释放激素激动剂(GnRH-a)从高位抑制下丘脑-垂体-性腺轴,减少患者血液中雌、孕激素,缩小子宫肌瘤体积,改善贫血及盆腔压迫症状。与口服药物相比,GnRH-a使用方便,患者依从性好,治疗效果确切。子宫肌瘤体积缩小,使腹腔镜手术及保留子宫的难度下降,术后恢复快。对于绝经过渡期、伴有严重合并症而无法耐受手术的患者,GnRH-a的应用还能使其避免或暂缓手术,控制合并症不进展。停用GnRH-a2周内垂体促性腺激素分泌可恢复,6～8周后可重建正常月经周期。

Uterine fibroids are the most common benign tumors in the female reproductive system,which can cause abnormal uterine bleeding,compression symptoms,abdominal pain and infertility.Currently the drug treatment effect is limited,it mainly relies on surgical treatment.GnRH-a inhibits the hypothalamic-pituitary-gonadal axis from a high position,reduces estrogen and progesterone in the blood of patients,reduces the volume of fibroids,and improves anemia and pelvic compression symptoms.Compared with oral drugs,it is easier to use,patient compliance is good,and the treatment effect is exact.The volume of the fibroids is reduced,which makes the laparoscopic surgery and the preservation of the uterus less difficult,and the postoperative recovery is fast.In patients with menopausal transition,with severe comorbidities and intolerance to surgery,the use of GnRH-a can also prevent surgery or suspend surgery,and control comorbidities.Pituitary gonadotropin secretion can be restored within 2 weeks,and normal menstrual cycle can be reconstructed after 6-8 weeks after stopping the usage of GnRH-a.