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This retrospective study analyzed the clinical characteristics and treatment outcomes of abnormal uterine bleeding in nonpregnant patients with hepatic cirrhosis. The researchers reviewed data from 72 women, finding that most were perimenopausal and that those with decompensated liver disease experienced more severe bleeding patterns, including hypermenorrhea and acute hemorrhage. Diagnostic curettage revealed endometrial pathological changes in 75% of cases, while follow-up indicated that conservative drug therapy was effective for some patients and hysterectomy was well-tolerated without complications. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.
Abstract
To investigate the clinical characteristics of abnormal uterine bleeding (AUB) in nonpregnant hepatic cirrhosis patients and to assess the treatment and curative effects of AUB. A retrospective analysis was conducted on 72 nonpregant AUB patients treated in Ditan Hospital from October 2008 to October 2009. Data were assessed with SPSS 10.0 and the constituent ratio was examined by chi-square tests. 58 out of the 72 nonpregnant AUB patients were climacteric patients (80.56%). Approximately 42.5% and 68.8% (x2=7.189, P = 0.027) of the AUB patients were diagnosed with compensated and decompensated liver cirrhosis, respectively, which presents a statistical significance. Among the 18 cases of AUB with hypermenorrhea, 12 were with compensated cirrhosis and 6 with decompensated cirrhosis, which makes a statistical significance with a chi-square result of 7.189, P = 0.027. 41 out of the 52 cases with diagnostic curettage (75.00%) were observed with pathological changes in endomembrane. During the three months to one year follow-up,10 of 67 patients showed effective expectant treatment and 16 cases with hysterectomia complained no postoperative complications. A high frequency of AUB was observed in nonpregnant cirrhosis patients. The main bleeding pattern of the nonpregnant AUB patients with cirrhosis is hypermenorrhea.
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肝硬化患者合并非妊娠异常子宫出血的诊断和治疗
The diagnosis and treatment of abnormal uterine bleeding in nonpregnant patients with hepatic cirrhosis
摘要目的 探讨肝硬化患者合并非妊娠异常子宫出血(AUB)的临床诊断和治疗特点.方法 对2008年10月-2009年10月在地坛医院住院的432例女性肝硬化患者按随机数字法抽取病历100份,检索其月经史;回顾性分析2005年12月-2009年12月诊断和治疗的72例肝硬化合并非妊娠AUB患者的临床资料.采用SPSS10.0软件进行统计分析,构成比用x2检验.结果 100例肝硬化住院女性患者中,61例(61%)有AUB记载,平均年龄(45.4±3.6)岁.4年间到妇科诊断和治疗的非妊娠AUB肝硬化患者72例,处于围绝经期患者58例(80.6%).代偿期及失代偿期肝硬化AUB患者中月经过多者分别为42.5%(17/40)、68.8%(22/32),两组患者比较,x2=7.189,P=0.027,差异有统计学意义.因AUB大出血急诊入院患者18例,代偿期及失代偿期肝硬化患者分别为6例、12例,两组患者比较,x2=4.80,P=0.028,差异有统计学意义.52例行诊断性刮宫,39例(75.0%)患者内膜有病理变化.随访3个月到1年,共随访67例,药物保守治疗的患者58.8%(10/17)有效;子宫切除的16例患者均无术后并发症发生.结论肝硬化女性患者非妊娠AUB的发生率较高,多发生在围绝经期,大部分患者子宫内膜有不同程度的病理变化.失代偿期肝硬化非妊娠AUB患者出血模式以月经过多为主,并且易发生子宫急性大出血.
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abstractsObjective To investigate the clinical characteristics of abnormal uterine bleeding (AUB) in nonpregnant hepatic cirrhosis patients and to assess the treatment and curative effects of AUB. Methods A retrospective analysis was conducted on 72 nonpregant AUB patients treated in Ditan Hospital from October 2008 to October 2009. Data were assessed with SPSS 10.0 and the constituent ratio was examined by chisquare tests. Results 58 out of the 72 nonpregnant AUB patients were climacteric patients (80.56%).Approximately 42.5% and 68.8% ( x 2 = 7.189, P = 0.027) of the AUB patients were diagnosed with compensated and decompensated liver cirrhosis, respectively, which presents a statistical significance. Among the 18 cases of AUB with hypermenorrhea, 12 were with compensated cirrhosis and 6 with decompensated cirrhosis,which makes a statistical significance with a chi-square result of 7.189, P = 0.027.41 out of the 52 cases with diagnostic curettage (75.00%) were observed with pathological changes in endomembrane. During the three months to one year follow-up,10 of 67 patients showed effective expectant treatment and 16 cases with hysterectomia complained no postoperative complications. Conclusion A high frequency of AUB was observed in nonpregnant cirrhosis patients. The main bleeding pattern of the nonpregnant AUB patients with cirrhosis is hypennenorrhea.
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