绝经后出血与妇科良性疾病125例临床分析

Clinical Analysis on postmenopausal bleeding in 125 cases of gynecological benign diseases

目的探讨绝经后出血(PMB)与妇科良性疾病的关系,以减少临床上过度诊断,过度治疗。方法128例患者均进行常规查体及妇科检查、经阴道彩色多普勒超声(TVCDS),部分行宫颈癌筛查和/或分段诊断性刮宫或手术治疗,内膜病理检查,行病因学分析。结果良性疾病125例,占PMB 97.66%,而良性病变中依次是炎症91例(72.8%),内分泌变化28例(22.4%),良性肿瘤6例(4.8%)。结论绝经后出血大部分是妇科良性疾病,以炎症居多。TVCDS是PMB的首选辅助检查方法,必要时诊刮术或宫腔镜检查。PMB患者不能忽视宫颈癌筛查,必要时行宫颈液基细胞学检查及人乳头瘤病毒(HPV)DNA检测。

Objective To investigate the relationship between postmenopausal bleeding（PMB） and benign gynecological diseases, and to decrease clinical excess diagnosis and treatment. Methods All 128 patients were examined with routine physical and gynecologic examination, TVCDS, partly by uterine cervix cancer screening and/or fractional curettage, the scrapings were sent for pathological examination and their etiological factors were analyzed. Results 125 cases （97.66%） of them were suffered with benign diseases. Among them, inflammation was seen in 91 cases （72.8%）, endocrine disorder in 28 cases （22.4%）, and benign tumors in 6 cases （4.8%）. Conclusion The etiological analysis showed that the most prevalent causes for postmenopausal bleeding were benign diseases, and inflammation was the commonest. TVCDS was the first auxiliary examination for PMB. If necessary, hysteroscopy or fractional curettage should be carried out. In patients with PMB, uterine cervical cancer screening cant be ignored. TCT and HPV DNA detection can be applied in suspectable cases.