绝经期子宫内膜增厚患者临床病理分析

Study on Pathological Features of Endometrium in Endometrial Thickening Postmenopausal Women

目的：研究绝经后子宫内膜增厚妇女的子宫内膜病理特点。方法：选取2010年1月~2012年12月绝经后子宫内膜增厚患者155例,根据有无临床症状分为A组（无症状组：66例）和B组（阴道出血组：89例）,对其临床及病理特点进行分析。结果：经病理组织学检查,A组66例患者中,正常绝经后改变者35例,占53.0%,良性病变者31例,占47.0%,未见恶性病变;B组89例患者中,正常绝经后改变者37例,占41.6%,良性病变者12例,占13.5%,恶性病变者40例,占44.9%。B组年龄明显低于A组,绝经年限也明显短于A组（P〈0.05）。A组的体重指数偏高于B组,但二者无统计学差异（P〉0.05）。B组患者肥胖、肥胖伴高血压及糖尿病患者子宫内膜复杂增生及内膜癌的比例高于A组。结论：在绝经后若无明显临床症状患者B超显示子宫内膜增厚者均为正常绝经后改变,部分呈良性病变,但对于既往存在超重、高血压、糖尿病等病史患者需谨慎对待,通过分段诊刮术排除恶性病变。

Objective：To study the pathological features of endometrium in endometrial thickening postmenopausal women.Methods：155 patients with postmenopausal endometrial thickening,were divided into group A（asymptomatic group：66 cases） and group B（vaginal bleeding group： 89 cases） and its clinical and pathological features were analyzed.Results：35 cases in A group were the normal postmenopausal changes,accounting for 53.0%.31 cases were benign lesions,accounting for 47.0%,and no malignant lesions.37 cases in B group were the normal menopause,accounting for 41.6%.12 cases were benign lesions（13.5%） and malignant lesions in 40 patients（44.9%）.The cases in group B were significantly lower than that in group A,and menopause also significantly shorter than that in group A（P〈0.05）.The rate of complex endometrial hyperplasia and endometrial cancer in patients with obesity,obese hypertensive in Group B is higher than that in the A group.Conclusion：If B ultrasound showed endometrial thickening postmenopausal changes in postmenopausal patients without obvious clinical symptoms,the patient with a history of overweight, hypertension and diabetes should be cautious,through the subDuan curettage exclude malignant lesions.