月經(jīng)失調(diào)課件

月經(jīng)失調(diào)月經(jīng)失調(diào)1AbnormalMenstrualCycleDysfunctionaluterinebleeding(DUB)功能失調(diào)性子宮出血Amenorrhea閉經(jīng)PCOS多囊卵巢綜合征Dysmennorrhea痛經(jīng)Premenstrualsyndrome(PMS)

經(jīng)前期綜合征Perimenopausalperiodsyndrome

圍絕經(jīng)期綜合征AbnormalMenstrualCycleDysfun2Dysfunctionaluterinebleeding

(DUB)Anovulatorydysfunctionalbleeding

無排卵性功能失調(diào)性子宮出血Ovulatorymenstrualdysfunction

排卵性月經(jīng)失調(diào)Dysfunctionaluterinebleeding3normalnormal4normalnormal5Dysfunctionaluterinebleeding(DUB)

AnovulatorydysfunctionalbleedingCauses:localorsystemic,includingpsychogenicPathologicphysiologywithdrawalbleedingorbreakthroughbleeding

撤退出血或突破出血1.adolescence2.postmenopausalvaginalbleedingDysfunctionaluterinebleeding6Dysfunctionaluterinebleeding(DUB)

AnovulatorydysfunctionalbleedingEndometrialchanges

1.endometrial

hyperplasia子宮內(nèi)膜增生癥（1）simplehyperplasia單純型增生（2）complexhyperplasia復(fù)雜型增生（3）atypicalhyperplasia不典型增生2.proliferativephaseendometrium增生期子宮內(nèi)膜3.atrophicendometrium萎縮型子宮內(nèi)膜Dysfunctionaluterinebleeding7Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingClinicmanifestation

irregularvaginalbleeding1.menorrhagia月經(jīng)過多2.hypermenorrhea經(jīng)量過多3.menometrorrhagia子宮不規(guī)則過多出血4.metrorrhagia子宮不規(guī)則出血Dysfunctionaluterinebleeding8Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDiagnosisaccordingto1.historyofpresentillness現(xiàn)病史2.menstrualhistory月經(jīng)史3.physicalexamination體格檢查4.otheradjuvantexaminations輔助檢查

Dysfunctionaluterinebleeding9Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDiagnosis4.otheradjuvantexaminationsincludingD&C診刮,Bultrasonography超聲,uterusmicroscopy宮腔鏡,measurementofBBTandhormone,etc.

基礎(chǔ)體溫及激素水平測(cè)定等

Dysfunctionaluterinebleeding10Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDysfunctionaluterinebleeding11Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDysfunctionaluterinebleeding12Dysfunctionaluterinebleeding(DUB)

Anovulatoryfunctionalbleeding

BBTofAnovulatoryfunctionalbleedingDysfunctionaluterinebleeding13Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDifferentialdiagnosis鑒別診斷

abnormalpregnancyandpregnancycomplications

異常妊娠或異位妊娠并發(fā)癥tumorofreproductivetract生殖道腫瘤infectionofreproductivetract生殖道感染unsuitableuseofhormoneandIUD

激素使用不當(dāng)或?qū)m內(nèi)節(jié)育器所致出血systemicdisease全身性疾病

Dysfunctionaluterinebleeding14Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDysfunctionaluterinebleeding15Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingTreatment1.generaltherapy一般治療(1)enoughnutritionandrest營(yíng)養(yǎng)和休息(2)antibioticsfortheoneoflongtimebleeding

流血時(shí)間長(zhǎng)者給予抗生素

Dysfunctionaluterinebleeding16Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDrugs:first-linetherapy一線治療1.hemostasia止血combinativeuseofsexhormone

性激素聯(lián)合用藥estrogen雌激素progestin孕激素andrin雄激素otherhemostaticdrugs其他Dysfunctionaluterinebleeding17Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDrugs2.adjustmentofmenstruation調(diào)整月經(jīng)周期estrogen-progestinsequentialtherapy

雌、孕激素序貫法estrogen-progestincombinativetherapy

雌、孕激素聯(lián)合法useofprogestininlatterperiodofthecycle

后半周期療法

Dysfunctionaluterinebleeding18Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDrugs3.levonorg-estrel-releasingIUD

宮內(nèi)孕激素釋放系統(tǒng)

4.inducedovulation促排卵Dysfunctionaluterinebleeding19Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingSurgicaltherapyuteruscurettage刮宮術(shù)endometrialablation子宮內(nèi)膜切除術(shù)uterotomy子宮切除術(shù)

Dysfunctionaluterinebleeding20Dysfunctionaluterinebleeding(DUB)

OvulatorymenstrualdysfunctionLutealphasedefect(LPD)黃體功能不足Irregularsheddingofendometrium

子宮內(nèi)膜不規(guī)則脫落Dysfunctionaluterinebleeding21Dysfunctionaluterinebleeding(DUB)

OvulatorymenstrualdysfunctionLPD

PathogenesisPathologyClinicalmanifestationpolymenorrhea,infertility,earlyabortion

月經(jīng)頻發(fā)，周期縮短，不孕，早期流產(chǎn)

DiagnosisTreatmentDysfunctionaluterinebleeding22Dysfunctionaluterinebleeding(DUB)

OvulatorymenstrualdysfunctionLUPDysfunctionaluterinebleeding23Dysfunctionaluterinebleeding(DUB)

OvulatorymenstrualdysfunctionIrregularsheddingofendometriumPathogenesisPathologyClinicalmanifestationnormalmenstrualcycle,月經(jīng)周期正常elongateddurationofepisode,經(jīng)期延長(zhǎng)excessiveinamount出血量多DiagnosisTreatmentDysfunctionaluterinebleeding24Dysfunctionaluterinebleeding(DUB)

OvulatorymenstrualdysfunctionIrregularsheddingofendometriumDysfunctionaluterinebleeding25月經(jīng)失調(diào)月經(jīng)失調(diào)26AbnormalMenstrualCycleDysfunctionaluterinebleeding(DUB)功能失調(diào)性子宮出血Amenorrhea閉經(jīng)PCOS多囊卵巢綜合征Dysmennorrhea痛經(jīng)Premenstrualsyndrome(PMS)

經(jīng)前期綜合征Perimenopausalperiodsyndrome

圍絕經(jīng)期綜合征AbnormalMenstrualCycleDysfun27Dysfunctionaluterinebleeding

(DUB)Anovulatorydysfunctionalbleeding

無排卵性功能失調(diào)性子宮出血Ovulatorymenstrualdysfunction

排卵性月經(jīng)失調(diào)Dysfunctionaluterinebleeding28normalnormal29normalnormal30Dysfunctionaluterinebleeding(DUB)

AnovulatorydysfunctionalbleedingCauses:localorsystemic,includingpsychogenicPathologicphysiologywithdrawalbleedingorbreakthroughbleeding

撤退出血或突破出血1.adolescence2.postmenopausalvaginalbleedingDysfunctionaluterinebleeding31Dysfunctionaluterinebleeding(DUB)

AnovulatorydysfunctionalbleedingEndometrialchanges

1.endometrial

hyperplasia子宮內(nèi)膜增生癥（1）simplehyperplasia單純型增生（2）complexhyperplasia復(fù)雜型增生（3）atypicalhyperplasia不典型增生2.proliferativephaseendometrium增生期子宮內(nèi)膜3.atrophicendometrium萎縮型子宮內(nèi)膜Dysfunctionaluterinebleeding32Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingClinicmanifestation

irregularvaginalbleeding1.menorrhagia月經(jīng)過多2.hypermenorrhea經(jīng)量過多3.menometrorrhagia子宮不規(guī)則過多出血4.metrorrhagia子宮不規(guī)則出血Dysfunctionaluterinebleeding33Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDiagnosisaccordingto1.historyofpresentillness現(xiàn)病史2.menstrualhistory月經(jīng)史3.physicalexamination體格檢查4.otheradjuvantexaminations輔助檢查

Dysfunctionaluterinebleeding34Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDiagnosis4.otheradjuvantexaminationsincludingD&C診刮,Bultrasonography超聲,uterusmicroscopy宮腔鏡,measurementofBBTandhormone,etc.

基礎(chǔ)體溫及激素水平測(cè)定等

Dysfunctionaluterinebleeding35Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDysfunctionaluterinebleeding36Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDysfunctionaluterinebleeding37Dysfunctionaluterinebleeding(DUB)

Anovulatoryfunctionalbleeding

BBTofAnovulatoryfunctionalbleedingDysfunctionaluterinebleeding38Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDifferentialdiagnosis鑒別診斷

abnormalpregnancyandpregnancycomplications

異常妊娠或異位妊娠并發(fā)癥tumorofreproductivetract生殖道腫瘤infectionofreproductivetract生殖道感染unsuitableuseofhormoneandIUD

激素使用不當(dāng)或?qū)m內(nèi)節(jié)育器所致出血systemicdisease全身性疾病

Dysfunctionaluterinebleeding39Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDysfunctionaluterinebleeding40Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingTreatment1.generaltherapy一般治療(1)enoughnutritionandrest營(yíng)養(yǎng)和休息(2)antibioticsfortheoneoflongtimebleeding

流血時(shí)間長(zhǎng)者給予抗生素

Dysfunctionaluterinebleeding41Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDrugs:first-linetherapy一線治療1.hemostasia止血combinativeuseofsexhormone

性激素聯(lián)合用藥estrogen雌激素progestin孕激素andrin雄激素otherhemostaticdrugs其他Dysfunctionaluterinebleeding42Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDrugs2.adjustmentofmenstruation調(diào)整月經(jīng)周期estrogen-progestinsequentialtherapy

雌、孕激素序貫法estrogen-progestincombinativetherapy

雌、孕激素聯(lián)合法useofprogestininlatterperiodofthecycle

后半周期療法

Dysfunctionaluterinebleeding43Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingDrugs3.levonorg-estrel-releasingIUD

宮內(nèi)孕激素釋放系統(tǒng)

4.inducedovulation促排卵Dysfunctionaluterinebleeding44Dysfunctionaluterinebleeding(DUB)

AnovulatoryfunctionalbleedingSurgicaltherapyuteruscurettage刮宮術(shù)endometrialablation子宮內(nèi)膜切除術(shù)uterotomy子宮切除術(shù)

D