Riesgo y beneficios de los análogos de GNRH y resultado postquirúrgico en miomatosis uterina
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2019
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Antecedentes: La miomatosis uterina es una de las enfermedades
ginecológicas más comunes, presentándose en el 30% en mujeres de edad fértil y el
70% de la población femenina. Estas tumoraciones son originadas de células de
musculo liso y ricas en matriz extracelular. Puede diagnosticarse por hallazgo en
examen de rutina. Presentan manifestaciones clínicas diversas, relacionadas con la
localización, tamaño y número de miomas, puede ser asintomática o presentar
hemorragia uterina anormal, dolor pélvico. Puede coexistir con otras enfermedades
ginecológicas y embarazo causando complicaciones con importantes repercusiones
en la salud. En cuanto al tratamiento del mioma uterino existen varias técnicas
quirúrgicas para su resolución así como tratamientos médicos farmacológicos
destinados a mejorar la sintomatología y condiciones clínicas, encontrando una
solución médica logrando mejorar el entorno quirúrgico. Dentro de los fármacos
más utilizados se encuentran los análogos de la hormona liberadora de
Gonadotropinas (GnRh), consiguiendo un estado de hipogonadismo
hipogonadotropo. Puede ser administrado por vía nasal, subcutánea, intramuscular
en preparados depot mensuales o trimestrales.
Metodología: El objetivo es determinar los riesgos y beneficios del uso de
análogos de GnRh en el tratamiento prequirúrgico de los miomas uterinos y su
correlación con los resultados postquirúrgicos. Se realizó un estudio caso control,
donde se estudiaron 72 pacientes que recibieron análogos de GnRh prequirúrgico y
72 pacientes que no recibieron el tratamiento, atendidas entre Enero del 2016 a
Junio del 2018.
Resultados: Se observaron beneficios del uso de análogos de GnRh
mediante diferentes variables así mismo como efectos adversos asociados a la
administración del fármaco.
Conclusiones: En base a las estadísticas realizadas se evidencio que post
cirugía en el particular caso de la Histerectomia la mayor parte de los paciente
necesitaron trasfusión sanguínea. Mientras que entre los días de hospitalización y
tiempo quirúrgico hubo una razón de semejanza no significativa del 197,94.
Uterine myomatosis is one of the most common gynecological diseases, occurring in 30% of women of childbearing age and 70% of the female population. These tumors are originated from smooth muscle cells and rich in extracellular matrix. It can be diagnosed by finding on a routine exam. They present diverse clinical manifestations, related to the location, size and number of myomas, can be asymptomatic or present with abnormal uterine hemorrhage, pelvic pain. It can coexist with other gynecological diseases and pregnancy causing complications with important health repercussions. Regarding the treatment of uterine fibroids, there are several surgical techniques for their resolution, as well as pharmacological medical treatments aimed at improving symptoms and clinical conditions, finding a medical solution, improving the surgical environment. Among the most commonly used drugs are Gonadotropin-releasing hormone analogs (GnRh), achieving a state of hypogonadotropic hypogonadism. It can be administered by nasal, subcutaneous, intramuscular route in monthly or quarterly depot preparations. The objective is to determine the risks and benefits of the use of GnRh analogs in the pre-surgical treatment of uterine fibroids and their correlation with post-surgical results. This Retrospective Explanatory Relational Type approach study of Quasi Experimental Analytical design is performed in patients diagnosed with uterine myomatosis at Teodoro Maldonado Carbo Hospital from January 2016 to June 2018. Benefits of using GnRh analogues were observed by different variables as well as adverse effects associated with drug administration.
Uterine myomatosis is one of the most common gynecological diseases, occurring in 30% of women of childbearing age and 70% of the female population. These tumors are originated from smooth muscle cells and rich in extracellular matrix. It can be diagnosed by finding on a routine exam. They present diverse clinical manifestations, related to the location, size and number of myomas, can be asymptomatic or present with abnormal uterine hemorrhage, pelvic pain. It can coexist with other gynecological diseases and pregnancy causing complications with important health repercussions. Regarding the treatment of uterine fibroids, there are several surgical techniques for their resolution, as well as pharmacological medical treatments aimed at improving symptoms and clinical conditions, finding a medical solution, improving the surgical environment. Among the most commonly used drugs are Gonadotropin-releasing hormone analogs (GnRh), achieving a state of hypogonadotropic hypogonadism. It can be administered by nasal, subcutaneous, intramuscular route in monthly or quarterly depot preparations. The objective is to determine the risks and benefits of the use of GnRh analogs in the pre-surgical treatment of uterine fibroids and their correlation with post-surgical results. This Retrospective Explanatory Relational Type approach study of Quasi Experimental Analytical design is performed in patients diagnosed with uterine myomatosis at Teodoro Maldonado Carbo Hospital from January 2016 to June 2018. Benefits of using GnRh analogues were observed by different variables as well as adverse effects associated with drug administration.
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Mioma, Embarazo, Factores de riesgo, Efectos adversos, Cirugía, Complicaciones posoperatorias, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador