不孕患者子宫内膜病变的临床病理分析

Clinical and pathological analysis of infertile patients with endometrial lesions

目的:探讨不孕患者子宫内膜病变的病理类型以及对治疗效果的影响。方法:选取不孕患者104例,于月经来潮后12h内行诊断性刮宫并进行病理分析。分泌反应类患者给予活血补肾为主的中医治疗,增生反应类患者给予克罗米芬口服。结果:子宫内膜病变中以分泌类反应较多,其中尤其以分泌欠佳所占比例最大,而增生类反应中以增生反应较多见。不同程度分泌异常患者随着病变严重程度增加,治疗效果也越来越差,组间比较差异明显,具有统计学意义(P<0.05)。不同类型增生异常患者治疗效果差别不大,无统计学意义(P>0.05)。结论:分泌类反应患者的病理诊断有助于对患者预后作出判断;增生类反应者虽然不同类型预后差别不大,但是治疗手段却不同,因此病理诊断也十分必要。

Objectives：To investigate the pathological type of infertility patients with endometrial lesions and their impact on the treatment effect.Methods：1 04 infertile patients were selected and applied diagnostic curet-tage within 1 2h since the beginning of menstrual period for pathological analysis.Patients in the secretory reaction class received Chinese medicine treatment highlighting Huoxue tonifying the kidney;patients in the proliferative re-sponse class were given oral clomiphene citrate.Results：Of the endometrial lesions,secretion response took the majority,especially poor secretion;while for the proliferation class,proliferative reaction was the majority.With the increasing severity degrees of diacrisis,treatment effect was getting worse and worse,with statistically significant differences between groups （P〈0.05 ）.For patients with different types of abnormal hyperplasia,treatment effect was not very different with no statistical significance （P〉0.05）.Conclusion：The pathological diagnosis of patients in the secretory response class is helpful to judge the prognosis;while for patients with proliferative response;al-though prognostic difference is not significant,treatment methods are different,so it is very necessary for pathologi-cal diagnosis.