功能失调性子宫出血(功血)是指由于女性内分泌功能紊乱而引起的异常子宫出血,经检查排除了全身和内外生殖器器质性疾病[1,2]。它实质是生殖内分泌功能或是子宫内膜局部调控异常。功血是妇科多发病和常见病,该病的发生呈上升趋势,且治疗后复发率高。在临床上如何及时、正确做出诊断,给患者合理的治疗,减少误诊,医学专家于2009年制定了《功能失调性子宫出血临床诊疗指南》[3]。功血的治疗通常药物治疗是第一选择,尤其对青春期功血。常用的内分泌药物止血方法有三种:孕激素、雌激素及复方短效避孕药。对有性生活史的尤其是围绝经期的女性可常规行诊刮术,必要时行宫腔镜及活检,明确内膜病理和排除生殖器恶性病变后,给予合理的药物治疗。对药物疗效不佳或不宜用药、无生育要求的患者,可采用手术治疗。本文就功血诊治方面的进展做一综述。 Dysfunctional uterine bleeding (dysfunctional uterine bleeding) refers to abnormal uterine bleeding due to endocrine dysfunction in women, which ruled out systemic and internal and external genital organic diseases [1,2]. It is essentially reproductive endocrine function or abnormal regulation of endometrial local. Dysfunctional blood is gynecological frequently-occurring disease and common disease, the incidence of the disease is on the rise, and the recurrence rate after treatment is high. In the clinical timely and correct diagnosis, to patients with reasonable treatment to reduce misdiagnosis, medical experts in 2009 developed a “functional dysfunctional uterine bleeding clinical diagnosis and treatment guidelines” [3]. Dysfunctional blood treatment is usually the first choice of medical treatment, especially for adolescent dysfunctional uterine bleeding. Commonly used endocrine drugs to stop bleeding in three ways: progesterone, estrogen and compound short-acting contraceptives. For sexual life history, especially menopausal women may routine curettage, if necessary, hysteroscopy and biopsy, clear endometrial pathology and exclude genital malignant lesions, to give a reasonable medication. Poor efficacy of the drug or should not medication, no fertility requirements of patients, surgery can be used. This article reviews the progress in the diagnosis and treatment of dysfunctional uterine bleeding.