40岁以上阴道不规则流血的临床分析

Clinical analysis of unregular vaginal bleeding of women over 40 years

目的40岁以上妇女阴道不规则流血的病因及诊断方法。方法对170例40岁以上妇女阴道不规则流血的资料进行回顾性分析。以绝经与否分为绝经组(A组)和未绝经组(B组)。结果病因的前三位依次为:未绝经组:功血(44.76%)、子宫肌瘤(33.33%)、恶性肿瘤(16.19%);绝经组:子宫内膜良性疾病(35.38%)、恶性肿瘤(32.31%)炎性疾病(15.38%)、绝经组与未绝经组相比较,绝经组恶性肿瘤发生率高于未绝经组(P<0.05);宫内膜癌发生率,绝经组明显高于未绝经组(P<0.01)。宫颈癌发生率两组无差异(P> 0.05)。结论对40岁以上妇女的阴道不规则流血,虽以良性疾病多见,但仍要注意常规检查和相应的辅助检查,特别是绝经后妇女,以排除恶性病变。

Objective: To analyse the cause and the methods of diagnosis for the regular vaginal bleeding of women over 40 years. Methods: 170 cases of unregular vaginal bleeding over 40 years were analysed in retrospect and to divide it into postmenopausal group (group A) and unmenopausal group (group B). Results: The causes of bleeding were dysfunctional uterine bleeding (44.76%), myoma uterus (33.33%) and malignant tumor (16.19%) in group B and benign endometrium disease (35.38%), malignant tumor (32.31%), infection disease (15.38%) in group A their proper order. The incidence of malignant tumor in group A is higher than group B (P<0.05) and the incidence of carcinoma of endometrium in group A was increased (P<0.01) comparing between the two groups. But the incidence of cervical cancer was no difference (P>0.05) between the two groups. Conclusions: Although most of the unregular requisite examinations must be finished in order toeliminate the maglinant disease for the unregular vaginal bleeding over 40 years and especially for postmenopausal women.