子宫内膜增生患者的临床特征分析

The Analysis of Endometrial Hyperplasia in Patients with Clinical Features

目的明确子宫内膜增生症患者的临床特征并为临床诊断、治疗提供依据。方法 2012年5月~2016年5月在潍坊医学院附属医院收治的行全子宫切除术、术后常规病理诊断为子宫内膜增生症患者78例,其中无不典型性子宫内膜增生41例(无不典组),不典型性子宫内膜增生37例(不典组),回顾性分析其年龄、BMI(体重指数)、合并症、家族史、月经改变情况、阴道流血情况以及B超检查结果与术中、术后病理的一致性。结果 1无不典组年龄(47.10±4.38)岁,不典组患者(49.68±5.45)岁,两组比较,差异均有统计学意义(P=0.023);2无不典组BMI 25.28±4.37,不典组BMI 27.35±2.72,两组比较,差异有统计学意义(P=0.015);3无不典组合并高血压病、糖尿病患者占24.39%,有家族史占4.88%,不典组合并高血压病、糖尿病患者占54.05%,有家族史占48.65%,两组比较,差异均有统计学意义(P<0.01);4无不典组子宫内膜厚度(1.11±0.35)cm,不典组(1.49±0.38)cm,两组比较,差异有统计学意义(P<0.01);5无不典组宫腔镜结果异常16例(n=24),不典组15例(n=16),两组比较,差异有统计学意义。结论对于围绝经期异常阴道流血女性,尤其是合并肥胖、高血压病、糖尿病情况下,应积极采取分段诊刮或宫腔镜检查,以明确诊断,警惕子宫内膜癌前病变的可能。

Objective To clarify the clinical features of patients with endometrial hyperplasia and to provide evidence for clinical diagnosis and treatment.Methods From May 2012 to May 2016,78 patients with diagnosis of endometrial hyperplasia admitted in the affiliated hosital of weifang medical university,divided into no atypical endometrial hyperplasia and atypical endometrial hyperplasia,which clinical features were retrospectively analyzed,including age,BMI（body mass index）,complications,family history,menstrual changes,vaginal bleeding,B ultrasonic examination,intraoperative and postoperative pathological consistency.Results 1The age of no atypical endometrial hyperplasia group was 47.10±4.38 years,the age of atypical endometrial hyperplasia group was 49.68±5.45 years,the difference between the two groups was statistically significant（P=0.023）;2The BMI of no atypical endometrial hyperplasia group was 25.28±4.37,the BMI of atypical endometrial hyperplasia group was 27.35±2.72,the difference was statistically significant（P=0.015）;3 In no atypical endometrial hyperplasia group,all the combinations and hypertension,diabetes accounted for 24.39%,a family history accounted for 4.88%,while atypical endometrial hyperplasia group was 54.05%and 48.65%,the difference was statistically significant（P〈0.01）;4The average endometrial thickness of no atypical endometrial hyperplasia group was（1.11±0.35） cm,the average BMI of atypical endometrial hyperplasia group was（1.49±0.38） cm,the difference was statistically significant（P〈0.01）.5In no atypical endometrial hyperplasia group,about 16 cases（n=24） with abnormal hysteroscopy results,in atypical endometrial hyperplasia group about 15 cases（n=16） with abnormal hysteroscopy results,the difference was statistically significant.Conclusion For abnormal vaginal bleeding perimenopausal women,especially with obesity,hypertension,diabetes cases,should take active curettage or hysteroscopy,to confirm the diagnosis,and to alert to the possibility of endometrial precancerous lesions.