青少年严重月经出血:在初级保健中发生率,诊断和管理实践
Stella J Van 't Klooster1, Anne de Vaan2, Jeanette van Leeuwen3
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Research and practice in thrombosis and haemostasis
|December 11, 2023
概括
很少有青少年因严重月经出血 (HMB) 咨询全科医生,这可能是出血障碍的潜在迹象. 大多数人接受荷尔蒙治疗,没有完全的诊断,转诊是罕见的,通常在多次访问后.
科学领域:
- 青少年健康 青少年健康
- 主要护理药物 医疗保健药物
- 血液学 血液学 血液学
背景情况:
- 严重的月经出血 (HMB) 影响37%的青少年,可能表明潜在的出血障碍 (BD).
- 荷兰的全科医生 (GP) 准则要求对处于危险的青少年进行诊断和转诊.
- 目前关于初级保健中HMB诊断和管理的实践尚不清楚.
研究的目的:
- 为了确定初级保健中的青少年中HMB的发病率.
- 确定用于青少年HMB的诊断和管理策略.
- 评估在初级保健中遵守HMB GP指南的情况.
主要方法:
- 荷兰GP网络数据库的回顾性分析 (2010-2020年).
- 纳入标准:年龄在10-21岁的青少年,新诊断的HMB和6个月的随访.
- 提取的数据:发病率,诊断测试,治疗和转诊模式.
主要成果:
- 发现了1879例新的HMB诊断;每1000人年发生率为7.91.
- 67%的病例缺乏诊断研究;31%只有血红蛋白测试.
- 荷尔蒙治疗 (56%) 和NSAIDs (18%) 是常见的;转诊发生在一次访问后的1.6%,在>2次访问后的6.7%.
结论:
- 在初级保健中,青少年HMB咨询的频率很少,尽管自我报告的患病率很高.
- 荷尔蒙避孕药通常在没有全面的出血障碍诊断的情况下被处方.
- 对HMB的转诊很少见,通常发生在多次GP访问后,这表明诊断和管理延迟.
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