785例阴道不规则出血的临床与病理分析

The Pathologic Analysis of Irregular Vaginal Bleeding for 785 Cases

目的:探讨阴道不规则出血的病因、病理,子宫内膜癌及癌前病变的关系,以达到早期发现,早期诊断,早期治疗的目的。方法:全部患者均进行常规查体及妇科检查,宫颈防癌刮片。行分段诊断性刮宫,部分行手术治疗,全部患者均行内膜病理检查。以绝经与否分为绝经组与非绝经组。结果:子宫内膜病理检查显示,主要为功能性内膜,功能失调性内膜,及其它。结论:生殖器官炎症和非器质性因素为引起出血主要原因,以功能性内膜及其他为主;绝经后妇女亦然,但绝经后出血应首先排除子宫内膜癌变导致长期不规则阴道出血的可能性,故绝经后早期开展定期妇科检查,积极治疗能引起绝经后出血的常见疾病,就可以减少恶性肿瘤的发生。

Objective： To investigate the pathogeny of irregular vaginal bleeding, the relationship of carcinoma endometrium and precarcinomatous pathological changes, and to gain the early detection, diagnosis and therapy. Methods. All patients received routine physical and gynecologic examination, and cervical scraping. Fractional curettage were executed and the scraped histology were sent to do pathologic examination. The patients were divided into postmenopausal and menopausal groups. Results： The pathologic examination showed that the most part of endometrium was functional endometrium and the second was dysfunctional endometrium . Conclusion： The reproductive organ inflammation and the nonorganic factor are the major reason causing the irregular vaginal bleeding, the most pathology is the functional endometrium, and it is the same cause to the postmenopausal group, but the possibility of endometrium carcinoma must be eliminated firstly, therefore the gynecologic examination should be taken on postmenopausal patients regularly. The common disease causing postmenopausal bleeding must be treated actively and the occurrence of malignant tumour can be reduced.