绝经后阴道出血650例临床病理分析

Clinicopathologic analysis of 650 colponhagia cases post menopause

目的 :探讨绝经后阴道出血 (PMB)的临床病理特点、病因及发病机理。方法 :全面分析PMB患者的临床资料及病理资料 ,所有患者均经诊断性刮宫或宫颈活组织检查。结果 :良性病变 5 17例 ,占 79 5 % ;恶性病变 94例 ,占 14 5 % (其中子宫内膜癌 5 9例 ,占恶性病变的 62 8% ) ;不典型增生 3 9例 ,占 6 0 %。宫颈病变引起出血 3 2 4例 ,占 49 8% ;宫体病变 3 0 6例 ,占 47 1% ;卵巢病变 2 0例 ,占 3 1%。结论 :PMB的病因主要是良性病变 ,但恶性肿瘤尤其是子宫内膜癌仍然是绝经后阴道出血的重要病因之一。PMB的病理类型与发病年龄及出血距绝经的年限有关 ,与出血量无明显关系。出血量的多少 ,在良、恶性病变中无显著差异。因此对年龄大、绝经年限长的阴道出血患者不论出血量多少都应高度重视 ,尽早进行病理检查 ,明确诊断 ,及时治疗。

Objective:To study the clinicopathologic characteristic ,pathogency and pathogenic mechanism of postmenopausal bleeding(PMB). Methods:The 650 cases with PMB were taken clinicopathologic analysis completely .For all of patients , diagnostic curettage,biopsy of cervix and pathologic examination have to do .Results:Among patients of the benign lesion are 517 cases(79.5%), the malignant leision are 94 cases(14.5%), 59 cases with PMB carcinoma of the endometrium account for 62.8% of malignant leision, atypical hyperplasia are 39 cases(6.0%), lesions of cervix cover 324 cases(49.8%), lesions of corpus uterus are 306 cases(47..1%), lesions of ovary are 20 cases (3.1%).Conclusion:the benign lesion is main pathogency of PMB, nevertheless carcinoma of the endometrium in mailgnant tumor is important cause of PMB. The pathologic type and pathogenic age of PMB relate to fixed number of years between bleeding and menopause,meanwhile it does not obviousely relate to amoumt of bleeding .There is not marked difference between benign and malignant .So in spite of much or little of amoumt of bleeding,must pay enough attention to colporrhagia patiengs who are more aged and with long yesrs of menopause. And must practice pathological examinations earlier,make clear its diagnosis and treat it in time.