合并血小板减少异常子宫出血患者全程管理的疗效分析  

Analysis of the effect of whole course management on patients with abnormal uterine bleeding complicated with thrombocytopenia

作　　者：赵旸[1,2] 侯弘毅 陈小友 韩茹雪 杨欣 ZHAO Yang;HOU Hongyi;CHEN Xiaoyou;HAN Ruxue;YANG Xin(Department of Obsterics and Gynecology,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院妇产科,100044 [2]北京美中爱瑞肿瘤医院 [3]河南省肿瘤医院妇科 [4]江西省南昌市新建区人民医院妇产科

出　　处：《中国妇产科临床杂志》2022年第6期575-578,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：北京大学人民医院研究与发展基金(RDY2017-20);北京市卫生健康科技成果和适宜技术推广项目(BHTPP202051)。

摘　　要：目的分析合并血小板减少的急重症异常子宫出血(abnormal uterine bleeding,AUB)患者治疗的效果及影响因素。方法收集2014年1月至2019年1月在北京大学人民医院因血小板减少导致的急重症异常子宫出血43例患者的临床资料,回顾性分析其急性止血和慢性维持期的治疗疗效。结果43例患者的平均年龄(40.56±9.94)岁,入院前血小板计数<50×10^(9)/L者占60.4%(26/43)。宫腔镜下止血1周内,完全止血者占37.20%(16/43),仍有少量淋漓出血者占62.80%(27/43)。术后随访6个月~5年AUB症状完全缓解者占30.2%(13/43),部分缓解者占39.5%(17/43),未缓解者占30.2%(13/43);术后是否应用控制月经的药物对维持期的症状长期改善有极显著影响(χ^(2)=15.84,P<0.001)。结论合并血小板减少的急重症AUB患者,宫腔镜下急性止血疗效较好,慢性维持期长期应用药物可有效预防复发。Objective To analyze the effects and influencing factors of acute and severe abnormal uterine bleeding(AUB)patients with thrombocytopenia.Methods The clinical data of 43 patients with acute and severe abnormal uterine bleeding caused by thrombocytopenia in Peking University People’s Hospital from January 2014 to January 2019 were collected.The efficacy of acute hemostasis and chronic maintenance were retrospectively analyzed.Results The mean age of 43 patients was(40.56±9.94)years,and the platelet count<50×10^(9)/L accounted for 60.4%(26/43).Within one week of hysteroscopic hemostasis,37.20%(16/43)patients had complete hemostasis,and 62.80%(27/43)patients still had a small amount of bleeding.The follow-up period ranged from 6 months to 5 years,30.2%(13/43)of AUB symptoms were completely relieved,39.5%(17/43)of AUB symptoms were partially relieved,and 30.2%(13/43)of AUB symptoms were not relieved.Whether to use drugs to control menstruation after operation had a very significant impact on the long-term improvement of symptoms during maintenance period(χ^(2)=15.84,P<0.001).Conclusions In patients with acute and severe bleeding who have thrombocytopenia,it is effective on hemostasis by intrauterine surgery.Long-term application of medicine treatment during the chronic maintenance period can effectively prevent recurrence.

关 键 词：异常子宫出血 血小板减少 手术止血 药物止血 

分 类 号：R558.2[医药卫生—血液循环系统疾病] R711.52[医药卫生—内科学]