Vercellini P, Vendola N, Ragni G, Trespidi L, Oldani S, Crosignani P G
L. Mangiagalli Obstetric and Gynecologic Clinic, University of Milan, Italy.
J Reprod Med. 1993 Jul;38(7):502-4.
We reviewed the clinical and histologic records of 61 consecutive premenopausal women with abnormal uterine bleeding and moderate to severe iron-deficiency anemia investigated in a tertiary care and referral center. Excessive bleeding was caused by benign lesions in 67% of the cases and by anovulation in 25% and was unexplained in 8%. Hysteroscopy revealed an organic intrauterine lesion (submucous myomas in 38%, endometrial polyps in 13%, submucous adenomyomas in 3%) that could be treated endoscopically in more than half the patients. In populations without nutritional deficiencies, a woman of reproductive age with sideropenic anemia and no other evident cause of blood loss or systemic disease should be considered menorrhagic until proven otherwise. Hysteroscopy should be included in evaluations of abnormal uterine bleeding.
我们回顾了在一家三级医疗和转诊中心接受调查的61例连续的绝经前异常子宫出血且患有中度至重度缺铁性贫血的女性的临床和组织学记录。67%的病例中出血过多是由良性病变引起的，25%是由无排卵引起的，8%原因不明。宫腔镜检查发现有器质性宫内病变（38%为黏膜下肌瘤，13%为子宫内膜息肉，3%为黏膜下腺肌病），半数以上患者可通过内镜治疗。在没有营养缺乏的人群中，育龄期患有缺铁性贫血且无其他明显失血原因或全身性疾病的女性，在未被证明有其他病因之前应被视为月经过多。宫腔镜检查应纳入异常子宫出血的评估中。
