绝经后阴道出血(附347例绝经后阴道出血原因分析)

Postmenopausal Vaginal Bleeding

绝经后阴道出血是老年妇女生殖器官疾病的常见症状,其中恶性肿瘤所致者较多见。本文就绝经一年以上的347例妇女发生阴道出血原因、诊断方法及治疗措施作一简要介绍。目的在于对比观察细胞学和组织学检查结果,为早期诊断和治疗老年生殖器官恶性肿瘤总结经验。

A retrospective study of 26,400 outpatients who presented to our department from December 1979 to May 1981 showed that 347 of them(1.3%)had postmenopausal vaginal bleeding one year or more following cessation of menstrual function,with the average age of 55 and the interval period of 1 to 5 years from the cessation of menses to the first vaginal bleeding in 49.5%of the cases.Of the 347 cases,45.8%were malignant tumors:33.1%cervical cancer,4%cancer of the endometrium(the incidence of the cervical cancer being 8.4 times that of the cancer of the endometrium),3.7%malignant tumor of the ovary,and a few cases of the cancer of the vulva,vagina and fallopian tubes.In addition,among the illnesses of nonmalig-nancy,senile vaginitis was the most common,accounting for 11.8%.The diagnostic aids we used included vaginal cytology,biopsy and endometrial histology,which proved to be of much help.Cervical and vaginal smears were used initially,excluding most of the non-malignant cases.Surgical treatment for the early stage of cancer was given to about one-third of the malignant cases and the other two-thirds received radiotherapy and chemotherapy.The treatment of the benign diseases was determined by their individual etiology.