功能失调性子宫出血2090911.ppt

DYSFUNCTIONAL UTERINE  BLEEDING 病例-1 病例-2 某女，47岁，因月经不规则一年就诊,诊断为子宫内膜癌，并行广泛性全子宫切除术。 功能性子宫出血是由于下丘脑-垂体-卵巢调节轴异常引起的异常阴道出血，无全身器质性病变。 概论 Outline 定义 Definition 症状 Symptoms 诊断 Diagnosis 治疗 Treatment 症状 --无特异性 失出了正常月经的特点： 月经过多 月经不规则 月经频发 月经过多不规则出血 诊断 – 排除法 Pregnancy 诊断 – 排除法 Pelvic pathologies 诊断 – 排除法 Contraception 诊断 – 排除法 Infection 诊断 – 排除法 诊断 – 排除法 Systemic diseases 治疗 Treatment Goals of management Control bleeding Prevent recurrence Preserve fertility Correct associated conditions Induce ovulation in patients who want to conceive 治疗 Treatment Surgical treatment D C Endometrial ablation Selective embolization hysterectomy 治疗 Treatment Medical treatment Hormone Estrogen Progesterone Combined OCs Goal of this lecture: * * 董卫红 M.D., Ph. D Department of OBGY Union Hospital of HUST E-mail:rubydwh@ 王某，女，14岁，月经来潮一年 因阴道大出血二十天，Hb 4g/L ,以功能性子宫出血，继发性贫血收入院，并给予输血治疗。 Why? 功血 Dysfunctional Uterine Bleeding DUB is defined as abnormal vaginal bleeding with no demonstrable organic cause, genital or extragenital. 异常阴道出血：除正常月经以外的阴道出血都为异常阴道出血 Abnormal Vaginal Bleeding is a flow of blood from the vagina that occurs either at the wrong time during the month or in inappropriate amounts 异常阴道出血 AVB DUB≠AVB We know: Drugs DUB≠AVB Knowledge is the strong medicine