月经失调PPT课件

BBT of Anovulatory functional bleeding
Dysfunctional uterine bleeding(DUB)
Anovulatory functional bleeding
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
月经失调
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)
1. 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
normal
normalБайду номын сангаас
Dysfunctional uterine bleeding(DUB) Anovulatory dysfunctional bleeding
Causes: local or systemic ,including psychogenic
Pathologic physiology withdrawal bleeding or breakthrough bleeding 撤退出血或突破出血 1.adolescence 2.postmenopausal vaginal bleeding
Diagnosis Treatment
Dysfunctional uterine bleeding(DUB) Ovulatory menstrual dysfunction
LUP
Dysfunctional uterine bleeding(DUB) Ovulatory menstrual dysfunction
Surgical therapy uterus curettage刮宫术 endometrial 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
经前期综合征 Perimenopausal period syndrome
围绝经期综合征
Dysfunctional uterine bleeding (DUB)
Anovulatory dysfunctional bleeding 无排卵性功能失调性子宫出血
Ovulatory menstrual dysfunction 排卵性月经失调
Dysfunctional uterine bleeding(DUB)
Anovulatory functional bleeding
Treatment 1.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
Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding
Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding
Irregular shedding of endometrium Pathogenesis Pathology Clinical 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 Diagnosis Treatment
Diagnosis according to 1. history of present illness现病史 2. 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
Dysfunctional uterine bleeding(DUB) Anovulatory dysfunctional bleeding
Endometrial changes
1.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
Dysfunctional uterine bleeding(DUB) Ovulatory menstrual dysfunction
Irregular shedding of endometrium
Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding
Drugs 2. 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 use of progestin in latter period of the cycle 后半周期疗法
2.proliferative phase endometrium增生期子宫内膜 3.atrophic endometrium萎缩型子宫内膜
Dysfunctional uterine bleeding(DUB) Anovulatory functional bleeding
Clinic manifestation irregular vaginal bleeding
Dysfunctional uterine bleeding(DUB)
Anovulatory functional bleeding
Drugs: first-line therapy 一线治疗 1. hemostasia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
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
子宫内膜不规则脱落
Dysfunctional uterine bleeding(DUB) Ovulatory menstrual dysfunction
LPD
Pathogenesis Pathology Clinical manifestation
polymenorrhea,infertility,early abortion 月经频发，周期缩短，不孕，早期流产
Diagnosis 4. other adjuvant examinations including D&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