| 摘要: |
| ［摘要］ 青春期异常子宫出血（AUB）以排卵功能障碍所致AUB（AUB-O）及凝血相关疾病所致AUB（AUB-C）最为常见。青春期AUB的出血模式主要为不规则出血、经期延长、月经过多（HMB）、经间期出血及无月经。《青春期异常子宫出血相关问题专家共识》强调通过详细的病史询问、体格检查和辅助检查对AUB病因进行鉴别诊断。对急性HMB的青春期女性，应及时、准确判断出血严重程度及生命体征，进行分级处理，评估应包括失血导致的贫血程度、血清铁蛋白水平、是否存在内分泌紊乱及凝血功能异常。对于急性HMB的青春期女性首要治疗方法包括短效口服避孕药及孕激素为主的药物紧急止血，但对于足量、规范用药治疗失败的部分难治性AUB患者，可以予手术治疗或子宫内膜病理评估。鉴于青春期AUB-O患者很难在短期内建立规律的月经周期、AUB-C患者长期存在HMB，均需要在急性期止血后维持用药以长期管理月经，避免异常出血的反复发作，并注意随访和监测。 |
| 关键词: 青春期异常子宫出血 排卵功能障碍 出血性疾病 月经过多 复方口服避孕药 专家共识 解读 |
| DOI：10.3969/j.issn.1674-3806.2025.05.04 |
| 分类号:R 711.52 |
| 基金项目:北京市卫生健康科技成果和适宜技术推广项目（编号：BHTPP202051）；白求恩公益基金“菲凡补铁——缺铁性诊疗能力提升项目”课题（编号：ffbt-A-2022-003） |
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| Interpretation of Expert Consensus on Issues Related to Abnormal Uterine Bleeding during Puberty |
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YANG Xin
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Department of Obstetrics and Gynecology, Peking University People′s Hospital, Beijing 100044, China
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| Abstract: |
| ［Abstract］ Abnormal uterine bleeding(AUB) during puberty is most commonly caused by ovulatory dysfunction(AUB-O) and coagulation-related diseases(AUB-C).The bleeding patterns of AUB during puberty are mainly irregular bleeding, prolonged menstrual period, heavy menstrual bleeding(HMB), intermenstrual bleeding, and absence of menstruation. Expert Consensus on Issues Related to Abnormal Uterine Bleeding during Puberty emphasizes the differential diagnosis of the etiology of AUB through inquiring a detailed medical history, physical examination, and auxiliary examinations. For adolescent females with acute HMB, the severity of bleeding and vital signs should be determined promptly and accurately, and the grade-based treatment should be carried out. The evaluations should include the degree of anemia caused by blood loss, serum ferritin levels, the presence or absence of endocrine disorders, and coagulation dysfunction. For adolescent females with acute HMB, the primary treatment methods include short-acting combined oral contraceptives and progestogen-based drugs for emergency hemostasis, but for some patients with refractory AUB who received adequate and standardized medications but the medications failed, surgical treatment or endometrial pathologic evaluation can be performed. Given that it is difficult for adolescent AUB-O patients to establish a regular menstrual cycle in a short term and that AUB-C patients have HMB in a long term, it is necessary to maintain medication after acute hemostasis to manage menstruation for a long time to avoid the recurrence of abnormal bleeding, and pay attention to follow-up and monitoring. |
| Key words: Abnormal uterine bleeding(AUB) during puberty Ovulatory dysfunction Bleeding disorders Heavy menstrual bleeding Combined oral contraceptives Expert consensus Interpretation |
