绝经后阴道流血326例临床分析

Clinical analysis on 326 cases with postmenopausal bleeding

目的:分析妇女绝经后阴道流血(PMB)的病因和诊断。方法:回顾性分析了2007年1月～2009年1月在该院门诊就诊及住院治疗的PMB 326例患者的临床及病理资料。结果:326例PMB患者中,生殖器炎症192例,占58.90%,功能失调性子宫出血70例,占21.47%,恶性肿瘤39例,占11.96%,其他25例,占7.67%。结论:PMB患者以良性病变为多,生殖系统炎症和功能失调性子宫出血是引起PMB的主要因素,恶性肿瘤所占比例较低,因此对PMB患者应先行常规妇科检查,明确出血部位,然后选择性行TCT、宫颈活体组织检查(活检)、ECC、子宫附件B超、分段诊断性刮宫(诊刮)、宫腔镜等检查,明确病因和诊断,对因治疗,以达到既不漏诊亦不过度检查和治疗。

Objective： To analyze the causes and diagnosis of female postmenopausal bleeding. Methods： The clinical and pathological data of 326 patients with postmenopausal bleeding from outpatient department and inpatient department of the hospital from January 2007 to January 2009 were analyzed retrospectively. Results： Among 326 patients with postmenopausal bleeding, 192 patients were diag- nosed as genital inflammation, accounting for 58.90%; 70 patients were diagnosed as dysfunctional uterine bleeding, accounting for 21.47% ; 39 patients were diagnosed as malignant tumor, accounting for 11.96% ; 25 patients were diagnosed as other diseases, accounting for 7.67%. Conelusion： The common causes of postmenopausal bleeding are benign lesions, genital inflammation and dysfunctional uterine bleeding are the major factors of postmenopausal bleeding, the proportion of malignant tumor is low, thus, the patients with postmenopausal bleeding should receive general gynecological examination at first, then the positions are confirmed, Thin Prep cytologic test （TCT）, cervical biopsy, ECC, type B uhrasonography of uteri and uterine adnexa, diagnostic fractional curettage, and hysteroscopy are carried out selectively to define the causes and diagnosis, and etiological treatment is carried out in order to achieve the gold of avoiding missed diagnosis, reasonable examination and treatment.