Graesslin O, Derniaux E
Institut Mère-Enfant Alix-de-Champagne, CHU, 45 rue Cognacq-Jay, 51092 Reims cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2008 Dec;37 Suppl 8:S384-97. doi: 10.1016/S0368-2315(08)74779-3.
Heavy menstrual bleeding is frequent, and can be caused by particular uterine abnormalities such as fibroids or adenomyosis but there is often no recognisable pathology. Surgery such as hysterectomy has proven its efficacy in treating these conditions, but alternatives techniques have been developed since many years and give interesting results. New medical treatments have also emerged, and in particular a new intrauterine levonorgestrel-releasing system (IUD-LNG). In case of dysfunctional uterine bleeding, the use of medical treatment should be considered in first line. Progestogens are often used in this condition even if it has been proven that they are less effective than antifibrinolytics, non steroid anti-inflammatory drugs or IUD-LNG. Appropriate treatment should be considered according to clinical conditions and based on efficacy, tolerance, cost and should also take into account the patient's wishes as observance in case of medical therapy is of particular importance. In case of DUB, medical therapy when correctly prescribed is effective.
月经过多很常见,可能由特定的子宫异常情况引起,如子宫肌瘤或子宫腺肌病,但通常没有可识别的病理变化。诸如子宫切除术等手术已证明其在治疗这些病症方面的疗效,但多年来也开发了替代技术并取得了有趣的成果。新的药物治疗方法也已出现,特别是一种新型的宫内左炔诺孕酮释放系统(IUD-LNG)。对于功能失调性子宫出血,应首先考虑使用药物治疗。即使已证明孕激素在这种情况下不如抗纤维蛋白溶解剂、非甾体抗炎药或IUD-LNG有效,但仍经常使用。应根据临床情况并基于疗效、耐受性、成本来考虑适当的治疗方法,还应考虑患者的意愿,因为药物治疗时的依从性尤为重要。对于功能失调性子宫出血,正确处方的药物治疗是有效的。