236例绝经后子宫内膜息肉的临床资料分析

Clinical analysis of 236 cases of postmenopausal endometrial polyps

目的探讨绝经后妇女子宫内膜息肉发生的相关因素及超声检查及病理特征,以及癌变的概率,讨论绝经后EP行宫腔镜检查的必要性。方法收集2010年1月至2014年1月间中国人民解放军总医院236例绝经后妇女EP患者的临床资料,讨论年龄、月经史、内科并发症与EP的相关性;分析比较不同年龄组绝经后EP的分布特征、形态特点、超声诊断特点和病理诊断特点。结果绝经后EP患者子宫正常或增大207例,占86.9%。息肉多发单发,约占67.4%,34.7%的病例患有高血压。超声下子宫内膜增厚,血流信号不丰富,腺肌瘤型息肉或伴有不典型增生、恶变的血流信号较丰富。绝经后EP恶变的几率1.7%。结论绝经后EP对雌激素刺激具有高度敏感性,绝经后EP有其病理性特征,常伴有不典型增生,恶变。宫腔镜手术有助于提高EP检出率;绝经后EP切除能够有效地阻止病变发展。

Objective To explore the characteristics of postmenopausal women with uterine endometrial polyps （EP） and to detect the rate of malignant of polys and the necessity of hysteroscopy. Methods Clinical data of 236 cases of postmenopausal women with endometrial polyps who admitted to Chinese PLA General Hospital from January 2010 to January 2014 were collected. Parameters of distribution, morphological, ultrasonic, hysteroscopic and pathological features between different age groups were analyzed. Results 207 of the 236 patients were with normal size or enlarged uterus which accounting for 87.7%. 67.4% of them were with single polyps. 34.7% of the patients suffered from hypertension. Ultrasound showed that most polyps cases had the character of endometrium thicken without blood flow, while adenomyoma polypoid, polys accompanied by atypical hyperplasia or canceration were with abundant blood flow signals. The rate of canceration was 1.7%. Conclusions Postmenopansal EP was sensitive to estrogen, it has the unique pathological characteristics, often accompanied by atypical hyperplasia and malignant transformation. Hysteroscopy can improve the detection rate of EP, and hysteroscopie resection of the endometium can effectively prevent the development of the lesions.