绝经后子宫内膜增厚的临床与病理分析  

Analysis on the clinical observation and pathologic type about endometrial thickness in postmenopausal

作　　者：郑凤英[1] 时青云[2] 吴姗姗[2] 

机构地区：[1]北京市通州区新华医院妇产科 [2]首都医科大学附属北京友谊医院,101100

出　　处：《中国妇幼保健》2007年第2期209-211,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨绝经后子宫内膜增厚的影响因素,并进行病理类型分析。方法:分析190例绝经后经B超检查子宫内膜厚度大于4 mm,并行诊断性刮宫及(或)子宫切除妇女的临床和病理资料。结果:①190例患者中,应用激素替代治疗(hormone rep lacem ent therapy,HRT)者68例占35.8%,高血压者37例占19.5%,应用他莫西酚者15例占7.9%。此3项是影响子宫内膜增厚的主要因素,其他因素有吸烟、不育、糖尿病;②子宫内膜厚度4 mm者48例,以萎缩性子宫内膜表现为主,未见有子宫内膜癌的发生;子宫内膜厚度57 mm者62例,以内膜增生、内膜增殖症为主,不典型增生2例,内膜癌6例;子宫内膜厚度89 mm者42例,其中内膜癌11例,非典型增生4例;子宫内膜厚度≥10 mm者38例,其中内膜癌15例,不典型增生6例,内膜癌的发病率明显增高。结论:子宫内膜癌与子宫内膜的增厚有密切相关性。绝经后子宫内膜厚度>4 mm者应行诊断性刮宫。Objective： To investigate factors associated with endometrial thickness and pathologic type in postmenopausal women. Methods： 190 postmenopausal women whose endometrial was thicker than 4 mm were examined by sonography. All of them were underwent curettage and/or hysterectomy and pathological examination. Results： ①68 of 190 （35.8%） postmenopsal women took HRT, 37 of the 190 women （19. 5% ） had hypertension, and 15 women （7.9%） took Tamoxifen drugs. The most important factors associated with endometrial thickness were the above three factors. Other factors were smoking, infertility and diabetes mellitus;②The most common pathologic type of 48 women whose endometrial thickness were 4 mm was hyperplasia. No cancer was found in this group. The most common pathologic type of 62 women whose endometfial thickness were 5 - 7ram was also hyperplasia , and six endometrial cancer were found in this group. Eleven endometrial cancer and four atypical hyperplasia cases were found in 42 women whose endometrial thickness were 8 - 9mm . Fifteen endometfial cancer and six atypical hyperplasia cases were found in 38 women whose endometrial thickness were ≥10 mm. The incidence rate of endometrial cancer in this group was greatly higher than other groups. Conclusion： One of the risk factors for endometrial cancer is shown to be endometrial thickness. Women with an endometrial thickness 〉4 mm should do curettage or endometrial biopsy.

关 键 词：绝经 子宫内膜增厚 子宫内膜癌 

分 类 号：R711.74[医药卫生—妇产科学]