1、Abnormal Menstrual Cycle（一） 月经失调（一）,Abnormal Menstrual Cycle,Dysfunctional uterine bleeding(DUB)功能失调性子宫出血 Amenorrhea 闭经 PCOS 多囊卵巢综合征 Dysmennorrhea 痛经 Premenstrual syndrome(PMS)经前期综合征 Perimenopausal period syndrome围绝经期综合征,Dysfunctional uterine bleeding (DUB),Anovulatory dysfunctional bleeding无排卵性功能失调
2、性子宫出血 Ovulatory menstrual dysfunction排卵性月经失调,normal,normal,Dysfunctional uterine bleeding(DUB) Anovulatory dysfunctional bleeding,Causes:local or systemic ,including psychogenic Pathologic physiologywithdrawal bleeding or breakthrough bleeding撤退出血或突破出血1.adolescence2.postmenopausal vaginal bleeding,D
3、ysfunctional uterine bleeding(DUB) Anovulatory dysfunctional bleeding,Endometrial changes1.endometrial hyperplasia 子宫内膜增生症（1）simple hyperplasia单纯型增生（2）complex hyperplasia 复杂型增生（3）atypical hyperplasia不典型增生2.proliferative phase endometrium增生期子宫内膜3.atrophic endometrium萎缩型子宫内膜,Dysfunctional uterine blee
4、ding(DUB) Anovulatory functional bleeding,Clinic manifestationirregular vaginal bleeding1. menorrhagia月经过多2. hypermenorrhea经量过多3. menometrorrhagia子宫不规则过多出血4. metrorrhagia子宫不规则出血,Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,Diagnosisaccording to1. history of present illness现病史2
5、. menstrual history月经史3. physical examination体格检查4. other adjuvant examinations辅助检查,Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,Diagnosis4. other adjuvant examinations includingD&C诊刮, B ultrasonography超声,uterus microscopy宫腔镜,measurement of BBT and hormone,etc.基础体温及激素水平测定等,Dys
6、functional uterine bleeding(DUB) Anovulatory functional bleeding,Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,BBT of Anovulatory functional bleeding,Dysfunctional uterine bleeding(DUB) Anovulatory functional b
7、leeding,Differential diagnosis鉴别诊断abnormal pregnancy and pregnancy complications异常妊娠或异位妊娠并发症tumor of reproductive tract生殖道肿瘤infection of reproductive tract生殖道感染unsuitable use of hormone and IUD激素使用不当或宫内节育器所致出血systemic disease全身性疾病,Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,D
8、ysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,Treatment1.general therapy一般治疗(1)enough nutrition and rest营养和休息(2)antibiotics for the one of long time bleeding流血时间长者给予抗生素,Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,Drugs: first-line therapy 一线治疗1. hemostasi
9、a止血combinative use of sex hormone 性激素联合用药estrogen雌激素progestin孕激素andrin雄激素other hemostatic drugs其他,Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,Drugs2. adjustment of menstruation调整月经周期estrogen-progestin sequential therapy 雌、孕激素序贯法estrogen-progestin combinative therapy雌、孕激素联合法us
10、e of progestin in latter period of the cycle后半周期疗法,Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,Drugs 3.levonorg-estrel-releasing IUD宫内孕激素释放系统 4.induced ovulation促排卵,Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding,Surgical therapyuterus curettage刮宫术endometr
11、ial ablation子宫内膜切除术uterotomy子宫切除术,Dysfunctional uterine bleeding(DUB) Ovulatory menstrual dysfunction,Luteal phase defect (LPD)黄体功能不足 Irregular shedding of endometrium子宫内膜不规则脱落,Dysfunctional uterine bleeding(DUB) Ovulatory menstrual dysfunction,LPD PathogenesisPathologyClinical manifestation polymen
12、orrhea,infertility,early abortion月经频发，周期缩短，不孕，早期流产 DiagnosisTreatment,Dysfunctional uterine bleeding(DUB) Ovulatory menstrual dysfunction,LUP,Dysfunctional uterine bleeding(DUB) Ovulatory menstrual dysfunction,Irregular shedding of endometriumPathogenesisPathologyClinical manifestation normal menstrual cycle ,月经周期正常 elongated duration of episode,经期延长excessive in amount出血量多 DiagnosisTreatment,Dysfunctional uterine bleeding(DUB) Ovulatory menstrual dysfunction,Irregular shedding of endometrium,
