Dysfunctional uterine bleeding: advances in diagnosis and treatment
Dysfunctional uterine bleeding: advances in diagnosis and treatment
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功能性子宫出血：诊断和治疗的进展
DOI：
10.1097/00001703-200110000-00006
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发表时间：
2001
影响因子：
2.1
通讯作者：
M. Munro
中科院分区：
文献类型：
--
作者：
M. Munro
功能失调性子宫出血发生在生殖年间，与子宫结构异常无关。排卵性功能失调性子宫出血继发于子宫内膜局部止血缺陷；而无排卵性功能失调性子宫出血是一种全身性疾病，继发于内分泌、神经化学或药物机制。对异常子宫出血患者的评估和对功能失调性子宫出血患者的识别是通过以下各项的组合实现的：病史；体检；以及合理使用实验室评估、子宫内膜采样和子宫成像、超声技术和/或宫腔镜检查。凝固性病变应该被考虑，就像壁内和浆膜下肌瘤不太可能导致AUB的概念一样。高质量的证据表明，药物治疗通常是成功的，而较新的方法，如通过宫内节育器局部注射孕激素，似乎特别有希望，而且没有全身副作用。对于那些不能忍受药物治疗的人，和/或不再需要生育的人，现在有一些微创的子宫切除术选择，统称为子宫内膜消融术。子宫内膜消融术可以在宫腔镜引导下进行，也可以不在宫腔镜引导下进行。越来越多的证据表明，即使宫腔镜手术是由专家进行的，非宫腔镜子宫内膜消融术可能至少和宫腔镜子宫内膜消融术一样有效。
Dysfunctional uterine bleeding occurs during the reproductive years unrelated to structural uterine abnormalities. Ovulatory dysfunctional uterine bleeding occurs secondary to defects in local endometrial hemostasis; while anovulatory dysfunctional uterine bleeding is a systemic disorder, occurring secondary to endocrinologic, neurochemical, or pharmacologic mechanisms. Evaluation of patients with abnormal uterine bleeding and identifying those with dysfunctional uterine bleeding is achieved with a combination of the following: history; physical examination; and judicious use of laboratory evaluation, endometrial sampling and uterine imaging, with sonographic techniques and/or hysteroscopy. Coagulopathies should be considered as should the notion that intramural and subserosal myomas are unlikely to contribute to AUB. High-quality evidence suggests that medical therapy is frequently successful, and newer approaches, such as local delivery of progestins via intrauterine devices, appear to be particularly promising and devoid of systemic side effects. For those intolerant of medical therapy, and/or for whom fertility is no longer desired, a number of minimally invasive surgical options for hysterectomy now exist and are collectively termed endometrial ablation. Endometrial ablation may be performed with or without hysteroscopic guidance. There is an increasing body of evidence that suggests that nonhysteroscopic endometrial ablation may be at least as effective as hysteroscopic endometrial ablation, even when the hysteroscopic procedure is performed by experts.
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影响因子：
4.8
作者：
Lockwood, CJ;Krikun, G;Schatz, F
通讯作者：
Schatz, F
前列腺素、催产素和内皮素-1 对人子宫肌层的体外收缩作用：孕妇子宫肌层组织对前列腺素 E2 和 F2 α 的耐药性。
DOI：
10.1210/jcem.75.4.1400867
发表时间：
1992
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
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通讯作者：
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影响因子：
3.9
作者：
McDonnell,S;Wright,JH;Gaire,M;Matrisian,LM
通讯作者：
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影响因子：
5.1
作者：
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通讯作者：
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影响因子：
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作者：
Zhang,J;Nie,G;Jian,W;Woolley,DE;Salamonsen,LA
通讯作者：
Salamonsen,LA