门诊宫腔镜对10565例异常子宫出血患者PALM-CORIN病因分类的应用

Clinical application of office hysteroscopy in the PALM-CORIN classification of causes of abnormal uterine bleeding

目的:探讨门诊宫腔镜及PALM-CORIN病因分类方法对异常子宫出血(AUB)患者病因、诊断、临床治疗的价值。方法:回顾分析2008年1月1日至2015年12月31日在湖北省妇幼保健院妇科门诊宫腔镜诊治中心因异常子宫出血就诊的10565例患者的临床资料,分析其就诊原因、阴道出血模式及宫腔镜检结果,并重新进行PALMCORIN分类,梳理其诊治流程。结果:10565例AUB患者的就诊原因和阴道出血模式依次为:月经频发、月经过多、月经期延长、不规律月经、月经异常合并不孕、经期间出血、月经过少、月经稀发,分别具有不同的PALM-CORIN病因分类。按PALM-COEIN病因分类系统,10565例AUB患者中,存在结构异常者4318例,占40.9%;存在非结构异常者6247例,占59.1%;非结构异常者的年龄显著高于结构异常者(P<0.05)。结构异常的患者中,病因分类排序依次为AUB-P、AUB-L、AUB-A、AUB-M;非结构异常的患者中,病因分类排序依次为AUB-O、AUB-I、AUB-E、AUB-N、AUB-C。结论:门诊宫腔镜和PALM-COEIN病因分类系统在AUB的诊治、分流中扮演着重要角色,有助于急慢性AUB患者的流行病学、病因学和治疗等多方面的研究。

Objective：To analyze the clinical application of office hysteroscopy and PALM-CORIN classification for causes of AUB in the reproductive years. Methods：A retrospec-tive analysis was made on the data of total of 10565 cases of AUB during 2008 to 2015 . Accord-ing to their different medical reasons,vaginal bleeding pattern and the result of office hysteros-copy,we administered the PALM-CORIN classification system for causes of AUB in the repro-ductive years. Results：The medical reasons and vaginal bleeding pattern were frequent menstru-ation,menorrhagia,menstruation prolong,irregular menstruation,infertility,intermenstual bleed-ing,oligomenorrhea,infrequent menstruation,which belong to different PALM-CORIN classifica-tion system for causes. In the structural abnormality group,PALM-CORIN classification of cau-ses are AUB-P、AUB-L、AUB-A、AUB-M while those are AUB-O、AUB-I、AUB-E、AUB-N、AUB-C in the nonstructural group. Conclusion：Office hysteroscopy and PALM-CORIN classifi-cation system for causes of AUB play an important role in the diagnosis and triage which should facilitate multi-institutional investigation into the epidemiology,etiology and treatment of women with acute and chronic AUB.