异常子宫出血

最后审阅: 7 九月 2022
最后更新: 27 五月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 子宫出血
更多 关键诊断因素

其他诊断因素

  • 药物使用
  • 月经不规则
  • 贫血
  • 经前期紧张
  • 多毛症、痤疮、黑棘皮症
  • 现有躯体疾病
其他诊断因素

危险因素

  • 处于生育年龄两端(青春期后和绝经前)的女性
  • 多囊卵巢综合征
  • 内分泌系统疾病
  • 其他无排卵性疾病
  • 肥胖
更多 危险因素

诊断性检查

首要检查

  • 妊娠试验
  • 全血细胞计数(FBC)
更多 首要检查

需考虑的检查

  • 凝血指标
  • 血清 TSH 水平
  • 超声检查
  • 宫腔镜检查
  • 子宫内膜活检
更多 需考虑的检查

治疗流程

初步治疗

子宫出血过多的紧急管理

急症处理

无排卵性 AUB:无孕激素和雌激素禁忌证

无排卵性 AUB:禁忌使用孕激素和雌激素

持续性治疗

对药物治疗耐药的显著子宫出血;希望未来有生育能力

对药物治疗耐药的显著子宫出血;未来无生育需求

撰稿人

作者

Janesh Gupta, MSc, MD, FRCOG

Professor of Obstetrics and Gynaecology

Centre for Women's and Newborn Health

Institute of Metabolism and Systems Research

University of Birmingham

Birmingham Women’s and Children’s Hospital

Birmingham

UK

利益声明

JG has received honouraria for consultancy for Femcare-Nikomed and Bayer, and support for attending meetings and travel from Medicem.

Akanksha Sood, MBBS, MS (OBGY), DNB, MRCOG, FACOG

Senior Clinical Fellow

Department of Reproductive Medicine

St. Mary’s Hospital

Manchester

UK

利益声明

AS declares that she has no competing interests.

Rohan Chodankar, MBBS, MD, MRCOG

Clinical Research Fellow

MRC Centre for Reproductive Health

The Queen's Medical Research Institute

University of Edinburgh

Scotland

UK

利益声明

RC is supported as a Clinical Research Fellow by Bayer AG; RC declares that he has no other competing interests.

鸣谢

Professor Gupta, Dr Sood, and Dr Chodankar would like to gratefully acknowledge Dr Mohamed Mitwally and Dr Intisar Elnahhas, the previous contributors to this topic. MM owns a patent on the use of aromatase inhibitors for endometrial thinning before hysteroscopic surgery. The patent is licensed to Meditrina Company. IE declares that she has no competing interests.

同行评议者

Janet Albers, MD

Associate Professor

Department of Family and Community Medicine

Southern Illinois University School of Medicine

Springfield

IL

利益声明

JA is an author of a reference cited in this topic.

Sarina Schrager, MD, MS

Associate Professor (CHS)

Department of Family Medicine

University of Wisconsin

WI

利益声明

SS declares that she has no competing interests.

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