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Medical therapy for fibroids: An overview

机译：肌瘤的医疗疗法：概述

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Uterine fibroids are the most common benign tumours in women of reproductive age group and are a cause of significant healthcare burden. Although surgical treatments have been the traditional gold standard for symptomatic uterine fibroids, several medical therapeutic approaches have been used to achieve symptom suppression in women who wish to preserve their uterus or are at elevated risk of complications during surgery. Medical therapies used for uterine fibroids include tranexamic acid, NSAIDs, contraceptive steroids, progesterone coil, GnRH analogues, aromatase inhibitors, SERMs and progesterone receptor modulators. The levonorgestrel containing intrauterine system reduces menstrual blood loss associated with fibroids, but drawbacks include the possibility of device expulsion and fitting difficulties. The use of GnRH agonists for 3-4 months prior to fibroid surgery can achieve reduction in uterine volume and fibroid size. They are beneficial in the correction of preoperative iron deficiency anaemia, if present, and reduce intra-operative blood loss. Although medical treatments provide effective symptom relief, women resorting to these therapies should be made aware of the high rates of future re-intervention. It is important for clinicians to recognise limitations of these therapies and that appropriate patient selection is of utmost importance. (C) 2017 Published by Elsevier Ltd.
机译：子宫肌瘤是生殖年龄组妇女中最常见的良性肿瘤，是一项重要的医疗保健负担的原因。虽然手术治疗是对症状子宫肌瘤的传统黄金标准，但是已经使用了几种医疗方法，以实现希望保存子宫或在手术期间并发症的升高风险的症状抑制。用于子宫肌瘤的医疗疗法包括宁甲酸，NSAIDS，避孕类固醇，孕酮线圈，GNRH类似物，芳香酶抑制剂，SERMS和孕酮受体调节剂。含有宫内系统的左旋醛rel降低了与肌瘤相关的月经失血，但缺点包括装置驱逐和拟合困难的可能性。在肌瘤手术前3-4个月的使用GnRH激动剂可实现子宫体积和肌瘤尺寸的降低。他们对术前缺铁性贫血的纠正有益，如果存在，并降低术中血液损失。虽然医疗治疗提供了有效的症状缓解，但应对这些疗法诉诸这些疗法的妇女意识到未来重新干预的高利率。对于临床医生来说，重要的是识别这些疗法的局限性，并且适当的患者选择是至关重要的。 （c）2017年由elestvier有限公司出版

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