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异常子宫出血,包括凝血障碍和其他月经紊乱。

Abnormal Uterine Bleeding including coagulopathies and other menstrual disorders.

机构信息

Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Obstetrics & Gynecology, National and Kapodistrian University of Athens, Medical School, "Aretaieion" Hospital, Vasilissis Sofias Avenue 76, 11528 Athens, Greece.

Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Obstetrics & Gynecology, National and Kapodistrian University of Athens, Medical School, "Aretaieion" Hospital, Vasilissis Sofias Avenue 76, 11528 Athens, Greece.

出版信息

Best Pract Res Clin Obstet Gynaecol. 2018 Apr;48:51-61. doi: 10.1016/j.bpobgyn.2017.08.016. Epub 2017 Oct 9.

Abstract

Abnormal Uterine Bleeding (AUB) is a frequent cause of visits to the emergency department and a major reason for concern among adolescents and their families. The most common cause of AUB, in otherwise healthy adolescents, is ovulatory dysfunction, although 5-36% of adolescents who present with heavy menstrual bleeding, have an underlying bleeding disorder (BD). The most common form of BDs is von Willebrand Disease, reflecting 13% of adolescents with AUB. Management of AUB depends on the underlying etiology, the bleeding severity, as well as the need for hospitalization. Treatment of adolescents with an underlying coagulopathy depends on the severity of the BD, while therapeutic interventions are summarized in supportive measures, hormonal treatments (e.g. Combined Oral Contraceptives), non-hormonal treatments (e.g. tranexamic acid and desmopressin), surgical options (e.g. dilatation & curettage) and treatment options in specific conditions.

摘要

异常子宫出血(AUB)是急诊就诊的常见原因,也是青少年及其家庭关注的主要问题。在其他方面健康的青少年中,AUB 最常见的原因是排卵功能障碍,尽管 5-36%的月经过多的青少年存在潜在的出血性疾病(BD)。BD 最常见的形式是血管性血友病,占 AUB 青少年的 13%。AUB 的管理取决于潜在病因、出血严重程度以及是否需要住院治疗。对潜在凝血功能障碍的青少年的治疗取决于 BD 的严重程度,而治疗干预措施总结在支持性措施、激素治疗(例如复方口服避孕药)、非激素治疗(例如氨甲环酸和去氨加压素)、手术选择(例如扩张和刮宫术)以及特定情况下的治疗选择中。

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