绝经后阴道流血的相关因素分析

Analysis of Correlative Factors for Postmenopausal Bleeding

目的：探讨绝经后阴道流血的病因和诊断。方法：对１８３例绝经后阴道流血患者的临床资料进行回顾性分析。结果：非器质性病变、良性疾病及恶性肿瘤引起的出血分别占 ３８．８％、 ３５．５％、２５．７％。子宫内膜病变引起的出血占 ７３．２％，其中以功能性出血为主，内膜癌次之。恶性肿瘤以子宫内膜癌及宫颈癌为主；年龄大，绝经时间长的患者恶性肿瘤发生率高；一些非器质性及良性病变可能发展为恶性肿瘤。结论：近年来非器质性及良性疾病成为绝经后出血的主要原因，但恶性肿瘤仍占一定比例。因此，对绝经后阴道流血者除注重常规的妇科检查外还应采取综合的检查手段，如Ｂ超、分段诊刮及宫腔镜等检查，配合活检尽早明确病因，早治疗可以减少肿瘤的发生率。

Objective: To find the correlative factors of postmenopausal bleeding (PMB). Materials and Methods: Clinical data from 183 patients of PMB were collected, whose clinical characteristics were analyzed retrospectively. Results: The PMB rates caused by nonorganic lesions, benign diseases, and malignant tumor (MT) were 38. 8 %, 35. 5 % and 25. 7 % respectively. 73. 2 % patients with PMB had endometrial lesions and nonorganic lesions while endometrial carcinoma seen the second cause. Cervical and endometrial carcinomas were the commonly seen MT. Elder patients with long term of menopauser would acquire the high incidence of MT. Some nonorganic lesions and benign diseases could also evolve into maliganaty tumor without treatment. Conclusion: Nonorganic lesions and benign diseases are the main causes of PMB in the last few years, but the malignant tumors still assume a definite proportion. Therefore, conventional gynecological examination, BUS, fractional curettage and hysteroscopy + biopsy should be applied earlier to obtain early treatment thus reduce the incidence of MT.