围绝经期异常子宫出血(AUB)发病率高,病因多样,极为复杂,其临床表现大多为月经紊乱即月经的周期频率、规律性、经期长度、经期出血量与正常月经不同,严重者导致患者贫血甚至休克,明确诊断其病因对指导临床个体化治疗尤为重要。随着诊疗的规范化,门诊医生根据患者的临床表现、妇科查体以及实验室检查能大致了解其基本情况,但明确其病因还需影像学检查以及病理学检查。阴道超声、诊断性刮宫以及宫腔镜检查被广泛应用于围绝经期AUB患者病因诊断中,现就以上三种诊断方式的临床效用进行综述,为临床医生选择个体化诊断方式提供一定参考。The incidence of abnormal uterine bleeding in perimenopause is high, the etiology is varied and extremely complicated. Its clinical manifestations are menstrual disorders, that is, menstrual cycle frequency, menstrual length, menstrual bleeding is different from normal menstruation. Severe cases can lead to anemia and even shock. The clear diagnosis of its etiology is very important to guide clinical individualized treatment. With the standardization of diagnosis and treatment, the outpatient doctor can get a general idea of the condition based on the patient’s clinical manifestations, gynecological examination and laboratory examination. However, the definitive cause of the patient depends on imaging and pathological examination. Vaginal ultrasound, diagnostic curettage and hysteroscopy are widely used in the etiological diagnosis of abnormal uterine bleeding in perimenopausal patients. This article summarizes the clinical effectiveness of the above three diagnostic methods in order to provide some references for clinicians to choose individualized diagnostic methods.
