异常子宫出血（AUB）是育龄期女性贫血的首要原因，其围手术期贫血显著增加手术风险并影响预后。因此，系统化的围手术期血液管理至关重要，包括：术前基于国际妇产科联盟（FIGO）PALM-COEIN分型明确病因，并通过实验室检查（血常规、铁代谢等）评估贫血严重程度及类型，针对急性AUB快速稳定生命体征、纠正凝血及补充铁剂或输血，慢性AUB则限期手术并积极纠正贫血（口服铁剂适用于术前4~8周，静脉铁剂尤其是第三代异麦芽糖酐铁起效更快、耐受性更佳）；术中优先微创、精细止血、监测失血、实施血液保护措施（如自体血回输），严格掌握异体输血指征；术后密切监测、预防出血并持续纠正贫血。长期管理旨在预防复发，核心在于根据病因选择手术或药物（如左炔诺孕酮宫内释放系统、激素治疗）控制出血，足疗程铁剂治疗重建铁储备，结合营养干预、生活方式调整、定期随访监测及患者教育，必要时多学科协作，以有效控制月经量、预防贫血复发，最终改善患者预后与生活质量。

Abnormal Uterine Bleeding （AUB） is the leading cause of anemia in women of reproductive age. Perioperative anemia associated with AUB significantly increases surgical risks and adversely affects patient outcomes. Therefore，a systematic perioperative blood management protocol is crucial. This includes： Preoperatively，make clear the etiology based on the FIGO PALM-COEIN classification system and assess the severity and type of anemia through laboratory investigations （routine blood test，iron metabolism，etc.）； for acute AUB，rapid stabilization of vital signs，correction of coagulopathy，and iron replenishment （or transfusion if indicated） are priorities； for chronic AUB，scheduling elective surgery along with vigorous anemia correction is necessary （oral iron is suitable for 4-8 weeks before operation，while intravenous iron，particularly third-generation agents like ferric derisomaltose，offers faster efficacy and better tolerance. Intraoperatively，minimally invasive techniques should be prioritized along with meticulous haemostasis，continuous blood loss monitoring，and blood conservation strategies （e.g.cell salvage），and allogeneic transfusion should be reserved for cases meeting strict criteria. Postoperatively，close monitoring，preventing bleeding and continued anemia correction are essential. Long-term management aims to prevent recurrence，focusing on controlling bleeding through surgery or medical therapies [e.g.Levonorgestrel-Releasing Intrauterine System （LNG-IUS），hormonal treatments] tailored to the underlying causes. This is combined with a full course of iron therapy to replenish stores，nutritional intervention，lifestyle modifications，regular follow-up monitoring，and patient education. A multidisciplinary approach is employed when necessary to achieve effective menstrual control，prevent anemia recurrence，and ultimately improve patient prognosis and quality of life.