绝经后阴道出血134例临床分析

Clinical and pathological analysis of 134 cases of postmenopausal bleeding

目的 分析引起绝经后阴道出血的病因及诊断方法。方法 对 13 4例绝经后阴道出血患者进行临床及病理分析。结果 因良性疾患引起出血占 58.2 0 % ,非器质性疾病占 3 2 .0 8%、恶性肿瘤占9.70 %。子宫内膜病理分析 :增生性反应 2 5例、分泌反应 3例、萎缩性 4例、破碎宫内膜和经期内膜 11例。恶性肿瘤以宫颈癌和子宫内膜癌为主 ,随着绝经后出血时年龄增加 ,绝经年期的延长 ,发生恶性肿瘤危险性也随之上升。诊刮中宫腔深度 >8.5cm发生恶性肿瘤可能性上升。结论 绝经后阴道出血虽以良性病变为主 ,但恶性肿瘤仍占有一定比例 ,同时随着绝经后出血时年龄增长 ,绝经年期延长恶性肿瘤的发生有增加 。

Objective To study the causes of postmenopausal bleeding and the method of diagnosis. Method 134 cases of postmenopausal bleeding were analyzed by clinical and pathological examination.Results The main causes of postmenopausal bleeding were as follows:benign cases (58.20%) nonorganic causes (32.08%) and malignant tumor (9.70%).Histopathological examination on endometrium was as follows:proliferative endometrium (25 cases) secretory endometrium (3 cases) atrophic endometrium (4 cases) and crushed endometrium and menoendometrium (11 cases).Endometrial and cervical cancers were common among the malignant tumors.The incidence of malignant tumor was higher in senile women with longer duration of menopanse.Those who had deep uterine cavity (>8.2 cm) had a higher incideme of malignant tumor.Conclusion Though benign cases are the main cases of postmenopausal bleeding,malignant tumors have certain proportion in the cases of postmenopausal bleeding.Therefore,we mustn't neglect postmenopausal bleeding.