论文部分内容阅读
目的 :对661例异常子宫出血(abnomal uterine bleeding,AUB)按PALM-COEIN病因分类进行相关诊断并探讨排卵障碍相关的AUB(AUB-O)和子宫内膜局部异常(AUB-E)治疗效果。方法:回顾性分析2013年1月至2016年3月江宁区妇幼保健所妇科门诊符合AUB诊断的661例患者临床资料,记录所有研究对象的年龄、体重、月经史、生育史等一般情况,采用PALM-COEIN分类系统进行病因分析,并统计对AUB-O和AUB-E患者行激素治疗的有效率。结果 :661例患者中结构异常性AUB为219例,占33.1%(其中AUB-子宫内膜息肉71例,占10.7%,AUB-子宫腺肌病68例,占10.3%,AUB-子宫平滑肌瘤51例,占7.7%,AUB-内膜恶变和不典型增生29例,占4.4%);非结构异常性AUB 442例,占66.9%(其中AUB-全身凝血相关疾病3例,占0.4%,AUB-O 245例,占37.1%,AUB-E 159例,占24.1%,AUB-医源性31例,占4.7%,AUB-未分类4例,占0.6%)。259例行诊刮术;AUB-O及AUB-E中155例给予雌孕激素(或孕激素)治疗3个月,其有效率分别为95.8%及97.1%,189例给予短效口服避孕药(OC)3个月的有效率分别为97.6%及96.9%,无明显不良反应。结论:临床上AUB的PALM-COEIN病因诊断中非结构异常较结构异常多见,且前者中AUB-O和AUB-E发生率占主导,对此类患者临床应用雌孕激素或口服避孕药治疗均有效,值得基层医院推广应用。
OBJECTIVE: To investigate the association between ovulation dysfunction-related AUB (AUB-O) and endometrial dysfunction (AUB-E) in 661 cases of abnomal uterine bleeding (AUB) according to the classification of the cause of PALM-COEIN. Methods: A retrospective analysis of 661 patients with gynecological outpatients who met AUB diagnosis from Jan. 2013 to Mar. 2016 in Jiangning District was performed. The clinical data of all the subjects including age, weight, menstrual history and fertility history were recorded. PALM -COEIN classification system for etiology, and statistics of AUB-O and AUB-E patients with hormone therapy efficiency. Results: The structural abnormalities of AUB were 219 (33.1%) in 661 patients (AUB-endometrial polyp in 71, accounting for 10.7%, AUB-adenomyosis in 68, accounting for 10.3%, AUB-uterine smooth muscle Tumor in 51 cases, accounting for 7.7%, AUB-endometrial malignant and atypical hyperplasia in 29 cases, accounting for 4.4%); non-structural abnormal AUB 442 cases, accounting for 66.9% (including AUB-systemic coagulation-related diseases in 3 cases, AUB-O 245 cases, accounting for 37.1%, AUB-E 159 cases, accounting for 24.1%, AUB-iatrogenic 31 cases, accounting for 4.7%, AUB-unclassified 4 cases, accounting for 0.6%). 259 routine curettage; AUB-O and AUB-E in 155 cases of estrogen and progesterone (or progestin) for 3 months, the effective rates were 95.8% and 97.1%, 189 cases were given short-acting oral contraceptives (OC) 3 months, respectively, the effective rate was 97.6% and 96.9%, no significant adverse reactions. Conclusion: AUB in the clinical diagnosis of PALM-COEIN etiology more common structural abnormalities, and the former AUB-O and AUB-E prevalence of such patients clinical application of estrogen and progesterone or oral contraceptives Are valid, it is worth promoting the application of primary hospitals.