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异常子宫出血的门诊诊断与管理

Office diagnosis and management of abnormal uterine bleeding.

作者信息

Tsai Ming C, Goldstein Steven R

机构信息

Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York, USA.

出版信息

Clin Obstet Gynecol. 2012 Sep;55(3):635-50. doi: 10.1097/GRF.0b013e31825d3cec.

Abstract

Abnormal uterine bleeding is one of the most common presenting complaints encountered in a gynecologist's office or primary care setting. The availability of diagnostic tools, such as ultrasound, endometrial sampling, and diagnostic hysteroscopy has made it possible to promptly diagnose and treat an increasing number of menstrual disorders in an office setting. The incorporation of newer medical therapies: antifibrinolytic drugs, shorter hormone-free interval oral contraceptive pills, and levonorgestrel inserts along with office minimally invasive treatments operative hysteroscopy and endometrial ablations have proven to be powerful therapeutic arsenals to provide short-term relief of abnormal uterine bleeding, and potentially, avoiding or delaying the hysterectomy.

摘要

异常子宫出血是妇科诊室或基层医疗环境中最常见的就诊主诉之一。超声、子宫内膜取样及诊断性宫腔镜检查等诊断工具的应用,使得在诊室环境中能够及时诊断和治疗越来越多的月经紊乱疾病。新型药物疗法(抗纤溶药物、缩短无激素间隔的口服避孕药及左炔诺孕酮宫内节育器)与诊室微创治疗(手术宫腔镜检查和子宫内膜消融术)相结合,已被证明是有效的治疗手段,可短期缓解异常子宫出血,并有可能避免或推迟子宫切除术。

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