绝经后304例阴道出血的临床及病理分析

Clinical and Pathologic Analysis of 304 Colponhagia Cases Post menopause

目的 对绝经后 30 4例阴道出血患者的临床病理资料 ,进行分析 ,并探讨其发病机理。方法 选择绝经后阴道流血年龄≥ 5 0岁者 2 85例 ,5 0岁以下 1 9例 ,经诊断性刮宫 ,宫颈活组织检查送病检进行病理分析。结果 良性病变占 84.9% ( 2 5 8例 ) ,恶性病变占 1 1 .5 % ( 35例 ) ,重度不典型增生 3.6% ( 1 1 )例 ,绝经后阴道流血患者中 ,以宫颈病变引起出血最多占 5 3% ( 1 61例 ) ,宫体病变占 44.7% ( 1 36) ,卵巢病变 2 .3% ( 7例 )。结论 绝经后阴道流血的类型与发病年龄和出血距绝经的年龄有关 ,而与出血量无明显关系 ,而出血量的多少 ,在良、恶性病变中 ,无显著差异 ( P>0 .0 5 )。因此对年龄大、绝经年限长的阴道流血患者 ,不管出血量的多少 ,均应高度重视 ,尽早进行病理检查 ,明确诊断 。

Objective By means of clinical and pathologic analysis of 304 colporrhagia cases,We explore pathogenic mechanism of postmenopausal bleeding.Methods Among patients of postmenopausal bleeding,over or including 50 year old are 285 cases,and below 50 year old are 19 cases.For all of patients,diagnostic curettage,biopsy of cervix and pathologic examinations have to do.Results Among patients of postmenopausal bleeding,the benign lesions are 84.9%(258 cases),the malignant lesions are 11.5%(35 cases),severe atypical hyperplasia are 3.6%(11 cases);lesions of cervix cover 53%(161 cases),which is most of all the patients,lesions of corpus uterus are 44.7%(136 cases),lesions of the ovary are 2.3%(7 cases).Conclusion The type and pathogenic age of postmenopausal bleeding relate to fixed number of years between bleeding and menopause,meanwhile it does not obviousely relate to amount of bleeding.For amount of bleeding,there is not marked difference between lesions of benign and malignant( P>0.05 ).So in spite of much or little of amount of bleeding,We must pay enough attentions to colporrhagia patients who are more aged and with long years of menopause.We must practice pathological examinations earlier,make clear its diagnosis and treat it in time.