子宫内膜息肉与异常子宫出血的相关特点分析

The relationship between the endometrial polyp and abnormal uterine bleeding

目的探讨子宫内膜息肉患者中异常子宫出血的临床特点及相关因素。方法回顾性分析2005年7月至2010年10月间于北京妇产医院诊治子宫内膜息肉的890例患者的临床症状、术中及术后情况,根据月经状况、有无异常子宫出血情况分组,分析比较一般情况、息肉的大小（〈1cm、1~2cm、〉2cm）、个数（单发、多发）、部位（宫底、宫角、前壁、后壁、侧壁）与异常子宫出血的相关性。结果①育龄期和绝经期子宫内膜息肉患者中,异常子宫出血的发生率分别为62.6%和47.4%,两者比较差异有统计学意义（P〈0.05）;②按子宫内膜息肉的大小进行分组,育龄期患者中异常子宫出血的发生率依次为32.0%、58.6%和69.2%,绝经期依次为42.1%、43.7%和56.3%,差异均有统计学意义（P〈0.05）。单发息肉患者和多发息肉患者中异常子宫出血的发生率在绝经期分别为49.2%、39.3%,差异有统计学意义（P〈0.05）;③宫腔镜下子宫内膜息肉切除术在育龄期患者的缓解率（69.8%,322/461）与绝经期（94.5%,69/73）比较差异有统计学意义（P〈0.05）。在育龄期和绝经期患者中,异常子宫出血的术后缓解率在单发息肉和多发息肉中比较差异均有统计学意义（P〈0.05）,但在息肉的大小和息肉的部位间比较差异无统计学意义（P〉0.05）。结论在子宫内膜息肉患者中,育龄期发生异常子宫出血的机率较绝经期高,息肉越大,异常子宫出血的发生率越高,对于单发息肉,宫腔镜手术能更好地改善异常子宫出血情况。

Objective To explore the clinical characters of the abnormal uterine bleeding in patients of polyp and to detect their relationship.Methods Data of eight hundred and ninety patients diagnosed as polyp from July 2005 to October 2010 were evaluated retrospectively.The relatiohship between abnormal bleeding and general situation,polyp number,diameter,site,clinical effect were anlyzed.Results ① The incidence of abnormal uterine bleeding was 62.6% in the reproductive patients,while was 47.4% in the postmenopausal women（P＆lt;0.05）.② In the reproductive group,the incidence of abnormal uterine bleeding was 32.0%,58.6%and 69.2% in the size of polyp＆lt;1cm,1~2cm and＆gt;2cm groups,while was 42.1%,43.7% and 56.3%in the menopausal group.The difference was significant（P＆lt;0.05）.③ Group the patients with the size of the polyp（＆lt;1cm,1~2cm,＆gt;2cm）. The incidence of abnormal bleeding in solitary poloyp（49.2%）was significant lower than that in multiple polyp（39.3%）（P＆lt;0.05）.There was positive correlation between the size and abnormal uterine bleeding（P＆lt;0.05,r＆lt;0.5）. Conclusions The incidence of abnormal uterine bleeding is higher in reproductive women.The size of the polyp is positive correlated with abnormal uterine bleeding.The surgery can relieve the symptoms better in solitary polyp group.