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本文讨论原发和继发闭经的发生原因、发病机理和诊断方法。两类闭经各有特点。原闭主要是由于先天异常及初潮前发生的病变所引起,其中性腺及生殖器官发育异常者约占60%。继闭主要是由于初潮后生殖系统的器质性或功能性病变所引起,按病变发生部位分子宫、卵巢、垂体、下丘脑性闭经进行讨论。闭经原因虽复杂,临床表现亦各有特征,但通过系统地询问病史,有计划地根据病变环节进行检查、分析,可以明确诊断,并指导今后的治疗。
This article discusses the causes of primary and secondary amenorrhea, pathogenesis and diagnostic methods. Two types of amenorrhea have their own characteristics. Primary closure is mainly due to congenital anomalies and lesions that occur before menarche, of which gonadal and reproductive organ dysplasia accounted for about 60%. Subsequent closure is mainly due to the reproductive system after menarche organic or functional lesions caused by the lesion site uterine, ovarian, pituitary, hypothalamic amenorrhea are discussed. Although the causes of amenorrhea are complex and their clinical manifestations also have their own characteristics, they can be diagnosed and guided in the future by systematic examination of the medical history and planned examination and analysis according to the pathological changes.