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RESUMEN La vitamina D está actualmente en el ámbito de la investigación en muchos campos de la medicina. Es conocido que tiene funciones fundamentales en el metabolismo del calcio y modelado óseo. La deficiencia de vitamina definida como la concentración de 25-hidroxicalciferol < 20 ng/mL es observada con frecuencia en pacientes con patologías ginecológicas. En las últimas dos décadas existe evidencia sobre la asociación de concentraciones séricas bajas de vitamina D con trastornos como diabetes mellitus y síndrome metabólico. Cada vez hay más informes que plantean el impacto del metabolismo de esta vitamina en el desarrollo de trastornos del sistema reproductor femenino. El receptor de vitamina D y la 1α-hidroxilasa están presentes en los órganos reproductivos, lo que sugiere que la vitamina D puede tener algún efecto en la modulación de las funciones celulares. Se ha comunicado los efectos perjudiciales de la deficiencia en pacientes con diagnóstico de síndrome de ovarios poliquísticos, endometriosis y leiomiomatosis. La suplementación de vitamina D debería agregarse a los esquemas de tratamiento de la mayoría de las patologías ginecológicas en pacientes con deficiencia, tanto por la mejora de la insulinorresistencia (como en las pacientes con síndrome de ovarios poliquísticos) como por los resultados del tratamiento de la infertilidad. El objetivo de esta revisión fue establecer los efectos de la deficiencia de vitamina D en patologías de la mujer en edad reproductiva.
ABSTRACT Vitamin D is currently under investigation in many fields of medicine. It is known to have fundamental functions in calcium metabolism and bone modeling. Vitamin D deficiency defined as 25-hydroxychalciferol concentration < 20 ng/mL and is frequently observed in patients with gynecological pathologies. In the last two decades there is evidence on the association of low serum vitamin D concentrations with disorders such as diabetes mellitus and metabolic syndrome. There are increasing reports of the impact of vitamin D metabolism on the development of disorders of the female reproductive system. Vitamin D receptor and 1α-hydroxylase are present in the reproductive organs, suggesting that vitamin D may have some effect in modulating cellular functions. The detrimental effects of deficiency have been shown in patients diagnosed with polycystic ovarian syndrome, endometriosis, and leiomyomatosis. Vitamin D supplementation should be added to the treatment schemes of most gynecologic pathologies in patients with deficiency, both for the improvement of insulin resistance (as in patients with polycystic ovarian syndrome) and for the outcomes of infertility treatment. The aim of this review was to establish effects of vitamin D deficiency on pathologies in women of reproductive age.
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Objective@#To summarize and analyze the treatment and nursing of diffuse uterine leiomyomatosis.@*Methods@#The clinical data of 16 patients with diffuse uterine leiomyomatosis admitted to Department of Obstetrics and Gynecology in Shengjing Hospital Affiliated to China Medical University from January 2009 to December 2016 were retrospectively analyzed, aiming at analyzing their treatment methods, perioperative indicators, nursing measures, etc., and analyzing the importance of nursing methods.@*Results@#Sixteen patients were treated with gonadotropin-releasing hormone agonist (GnRH-a) after abdominal myomectomy. The surgical procedures of 16 patients were smooth. The average operative time was 123.56 (45-190) min, the average intraoperative blood loss was 225.00(100-600) ml, the average number of fibroids resected during the operation was 61.63(16-135), the average extraction time was 4.06(3-6)days, the average postoperative time of indwelling catheter was 1.94(1-4)days, the average postoperative time of leaving the bed was 1.94(1-4) days, the average postoperative exhaust time was 1.81(1-3) days, and the average postoperative hospital stay was 5.25(4-7) days. Among them, 1 patient had postoperative intestinal fistula, which was cured after conservative treatment. Blood transfusion was performed for 8 patients with hemoglobin lower than 70 g/L. All patients received preoperative psychological nursing and postoperative comprehensive nursing, and were discharged successfully.@*Conclusions@#Transabdominal myomectomy plus GnRH-a treatment is an option for patients with diffuse uterine leiomyomatosis who want to preserve fertility. Do perioperative nursing seriously, can shorten the length of hospital stay, improve the cure rate.
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Objective To summarize and analyze the treatment and nursing of diffuse uterine leiomyomatosis. Methods The clinical data of 16 patients with diffuse uterine leiomyomatosis admitted to Department of Obstetrics and Gynecology in Shengjing Hospital Affiliated to China Medical University from January 2009 to December 2016 were retrospectively analyzed, aiming at analyzing their treatment methods, perioperative indicators, nursing measures, etc., and analyzing the importance of nursing methods. Results Sixteen patients were treated with gonadotropin-releasing hormone agonist (GnRH-a) after abdominal myomectomy. The surgical procedures of 16 patients were smooth. The average operative time was 123.56 (45-190) min, the average intraoperative blood loss was 225.00(100-600) ml, the average number of fibroids resected during the operation was 61.63(16-135), the average extraction time was 4.06 (3- 6)days, the average postoperative time of indwelling catheter was 1.94(1- 4)days, the average postoperative time of leaving the bed was 1.94(1-4) days, the average postoperative exhaust time was 1.81 (1-3) days, and the average postoperative hospital stay was 5.25(4-7) days. Among them, 1 patient had postoperative intestinal fistula, which was cured after conservative treatment. Blood transfusion was performed for 8 patients with hemoglobin lower than 70 g/L. All patients received preoperative psychological nursing and postoperative comprehensive nursing, and were discharged successfully. Conclusions Transabdominal myomectomy plus GnRH-a treatment is an option for patients with diffuse uterine leiomyomatosis who want to preserve fertility. Do perioperative nursing seriously, can shorten the length of hospital stay, improve the cure rate.