阴道不规则出血的临床研究

The clinical research of vaginal irregular haemorrhage

目的分析临床中阴道不规则出血的病因、病理,以提供临床参考资料。方法随机送检431例因阴道不规则出血而就诊的患者宫内刮出物做常规石蜡切片,HE染色,显微镜观察。结果两组病史分析显示,除单纯阴道出血外,绝经后妇女阴道出血病史中合并应用HRT、子宫肌瘤、宫腔占位、宫颈息肉等占46.14%,非绝经妇女中,以子宫肌瘤、功内节育器放置、功血史等为多见。宫颈病理中宫颈内膜炎与宫颈内膜息肉是宫颈因素中引起阴道不规则出血的主要原因。宫腔病理显示,绝经组常见的为老年萎缩性内膜,其次为粘液、内膜息肉等,但子宫内膜癌发生率高(71.4%);非绝经组,以增殖期、分泌期为多见(71.19%),其次为子宫内膜增生,但子宫内膜癌发生率较低,为0.17%。出血时间分析,绝经后少量、长时间阴道出血提示癌变可能性大。结论绝经期与非绝经期阴道不规则出血以宫颈、宫腔的良性病变为多见,但绝经后出血应首先排除子宫内膜癌变。

Objective To analyse the etiology and pathology of vaginal irregular haemorrhage, in order to provide reference for clinical data. Methods Random inspection 431 cases of vaginal bleeding and attendance of irregular objects within the scraping out patients with conventional paraffin section, He dyeing and microscope. Results Two groups of history analysis showed that, besides pure vaginal bleeding in postmenopausal women vaginal bleeding, combined application requires HRT, uterine fibroids, uterine cervical polyp of sites, such 46. 14% , not in postmenopausal women, uterine fibroids, reactive power, JieYuQi placed in history was seen as the blood. Cervical pathology in cervical lining with cervical endometritis cervical polyp was caused by irregular vaginal bleeding in the factor of the main reason. Uterine pathology revealed that the common for older postmenopausal group, followed by mucus atrophic endometrial polyps, etc, but the endometrium and endometrial cancer incidence was the highest 71.4%. The postmenopausal group, with many secretory proliferation, （71.19%） , and secondly, endornetrial hyperplasia of endometrial cancer but a low incidence （0. 17% ）. Postmenopausal bleeding time analysis, a long time, vaginal bleeding clew cancerous possibility. Conclusion The menopause and menopause vaginal bleeding, uterine cervical irregular with benign lesions is seen in postmenopausal bleeding, but should be first except endometrial cancer.