Goyal Navin, Gore Madhuri A, Shankar Ravi
Department of General Surgery, LTM Medical College, Sion, Mumbai, India.
Burns. 2008 Sep;34(6):825-8. doi: 10.1016/j.burns.2007.12.001. Epub 2008 Apr 9.
Galactorrhea and/or amenorrhea, although uncommonly reported in post-burn patients, is a complex problem to treat. Patient is reluctant to volunteer history of these symptoms, unless asked specifically.
To study profile of adult female patients with galactorrhea and/or amenorrhea in post burn period.
A prospective study of all adult female patients presenting with or detected to have galactorrhea and/or amenorrhea in post burn period was conducted over 6 month's period. Detailed clinical examination, estimation of LH, FSH, Prolactin levels and X-ray of skull was done in all patients. The data collected was analyzed. Patients with hyperprolactinemia and galactorrhea were treated with Bromocriptine for 3 weeks to 3 months. In all patients with amenorrhea, pregnancy was ruled out by gynecological examination and urine pregnancy test.
During this period, 30 patients (15.15%) were detected to have galactorrhea and/or amenorrhoea. The extent of burn in these patients was 20-65%of body surface area. Out of 30 patients, 5 had galactorrhea and amenorrhea, 1 galactorrhea alone and 24 had amenorrhea alone. Analysis of voluntary disclosures and detection on interrogation was done. Till the end of study, 4 patients with galactorrhea had complete relief, 2 patients reported reduction in discharge.
Galactorrhea was distressing for all and was always associated with high prolactine levels .The reverse was not true. All the patients had chest burns besides other body areas. Association was noted between menstrual aberration and ovulatory phase at the time of burn.
Galactorrhea and menstrual disturbances do exist in female patients in reproductive age group in post burn period and patients should be especially interrogated for these symptoms by the burn care providers.
溢乳和/或闭经在烧伤后患者中虽鲜有报道，但却是一个复杂的治疗难题。除非特别询问，患者往往不愿主动提及这些症状的病史。
研究成年女性烧伤后溢乳和/或闭经患者的情况。
对所有成年女性烧伤后出现或被检测出有溢乳和/或闭经的患者进行了为期6个月的前瞻性研究。对所有患者进行了详细的临床检查、促黄体生成素（LH）、促卵泡生成素（FSH）、催乳素水平测定及颅骨X线检查。对收集的数据进行了分析。高催乳素血症和溢乳患者用溴隐亭治疗3周至3个月。所有闭经患者均通过妇科检查和尿妊娠试验排除妊娠。
在此期间，30例患者（15.15%）被检测出有溢乳和/或闭经。这些患者的烧伤面积为体表面积的20%至65%。30例患者中，5例既有溢乳又有闭经，1例仅有溢乳，24例仅有闭经。对主动披露情况和询问时发现情况进行了分析。到研究结束时，4例溢乳患者完全缓解，2例患者报告溢乳量减少。
溢乳对所有患者来说都很痛苦，且总是与高催乳素水平相关。反之则不然。所有患者除身体其他部位外胸部均有烧伤。注意到月经紊乱与烧伤时的排卵期之间存在关联。
育龄期女性烧伤后确实存在溢乳和月经紊乱，烧伤护理人员应特别询问患者这些症状。
