围绝经期与绝经后异常子宫出血原因的分析

Etiology of Abnormal Perimenopausal and Postmenopausal Uterine Bleeding

目的探讨围绝经期与绝经后异常子宫出血的原因.方法结合B超检查、分段诊刮、宫腔镜检查及病理检查等多种方法,对394例围绝经期异常子宫出血及201例绝经后异常子宫出血患者进行回顾性分析,了解异常子宫出血的原因.结果围绝经期组异常子宫出血的病因构成比分别是:非器质性因素17.5%、良性病变68.8%、恶性肿瘤及癌前病变13.7%;绝经后组异常子宫出血的病因构成比分别是:非器质性因素28.4%、良性病变37.7%、恶性肿瘤及癌前病变34.3%.围绝经期组与绝经后组的病因构成比的差别具有统计学意义(P<0.01).结论围绝经期异常子宫出血以良性病变为主,绝经后异常子宫出血以良性病变、恶性肿瘤及癌前病变为主.结合B超检查、分段诊刮、宫腔镜检查及病理检查等检查手段能对围绝经期与绝经后异常子宫出血的患者做出病因诊断.

Objective To analyze the cause of perimcnopausal and postmenopausal abnormal uterine bleeding （AUB）. Methods 394 cases of perimenopausal and 201 cases of postmenopausal AUB were retrospectively studied. Ultrasonography, diagnostic fractional curettage, hysteroseopy and pathological examination were used to define the cause of AUB. Results In perimenopausal group, the constituent ratio of the cause of AUB was 17.5% for non -organic factors, 68. 8% for benign lesions, and 13.7% for precancerous and malignant lesions respectively. In postmenopausal group, the constituent ratio was 28.4%, 37.7% and 34. 3% respectively. The inter- group differences were statistically significant （ P 〈0. 01 ）. Conclusions Perimenopausal AUB are mainly caused by benign lesions, while benign lesions, precancerous and malignant lesions account for the majority of the cause of postmenopausal AUB.