绝经后阴道出血548例临床分析

Clinical analysis of postmenopausal bleeding in 548 cases

目的 探讨绝经后阴道出血的病因和诊断。方法 对2000年1月至2003年12月经我院妇科活检或手术后病理证实的绝经后阴道出血548例患者的临床资料进行回顾性分析。结果 按病理分类:良性疾病引起的绝经后出血占70 .3%,非器质性疾病占18 .2%,恶性疾病占11. 5%。良性疾病中以慢性宫颈炎最常见,恶性疾病以宫颈癌和子宫内膜癌为主。结论 绝经后阴道出血的首位病因为良性疾病,其次是非器质性疾病,恶性疾病为第三位。绝经时间长的阴道出血,恶性肿瘤的发生率明显增高。对绝经后阴道出血应引起重视,常规行妇科检查结合必要的辅助检查可明确诊断。

Objective To investigate the causes and diagnosis of postmenopausal bleeding.Methods The clinical data of 548 patients admitted to our hospital from January 2000 to December 2003 were analyzed retrospectively for postmenopausal bleeding with pathologic diagnosis after biopsy or uterectomy.Results Classified pathologically:benign causes of postmenopausal bleeding,70.3%,nonorganic causes,18.2%,and malignant causes,11.5%.Chronic cervicitis in benign causes were the most common(26.6%).Cervical carcinomas and endometrial cancers in malignant causes were mian(total 10.1%).Conclusions The first etiology of postmenopausal bleeding was benign causes.The next etiology was nonorganic causes.The third was the malignant causes.With the year of menopause prolonging,the incidence of malignant tumor increased.More attention should be paid to postmenopausal bleeding patients.Routine gynecologic and necessary ancillary examination can identify the cause of postmenopausal bleeding.