子宫异常出血患者子宫内膜病理状况分析  

Analysis of current situation of 712 patients' endometrial pathology by diagnostic curettage

作　　者：宋巧丽[1] 郑飞云[1] 刘自杰[1] 

机构地区：[1]浙江省温州医学院附属第一医院,浙江温州325000

出　　处：《中国妇幼健康研究》2008年第2期131-133,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨诊断性刮宫（简称诊刮）及子宫内膜病理检查对子宫异常出血的诊断价值，减少临床误诊率。方法收集2006年1月-2006年12月就诊于浙江省温州医学院附属第一医院的712例子宫异常出血患者，依据患者年龄分为生育期和围绝经期两组，通过分析诊刮后子宫内膜病理学类型及不同年龄段子宫内膜病变情况，探讨诊刮的价值。结果生育期和围绝经期妇女中以功能性失调性子宫出血（简称功血）为多见（360／712），占50．56％，其中均以无排卵型为主（286／360），占79，44％；内膜增生过长的病理类型从简单型增生、复杂型增生、不典型增生、内膜癌有随年龄增高趋势；内膜癌患者主要集中在围绝经期。结论两组患者子宫异常出血患病率相似，诊刮、子宫内膜病理检查及对病变的综合分析是做好子宫异常出血诊断、鉴别诊断及正确治疗的关键。Objective To evaluate diagnostic values of diagnostic curettage and pathological examination of endometrium for abnormal uterine bleeding and to reduce clinical misdiagnosis rate. Methods 712 patients with abnormal uterine bleeding visited the gynecologist in The First Affiliated Hospital of Wenzhou Medical College from January to December in 2006 were selected and divided into two groups-- childbearing age group and perimenopausal period group according to their age. The pathological classification of their endometrial specimen by diagnostic curettage and pathologic changes of the patients with different age were analyzed. Thereby, the value of diagnostic curettage was evaluated. Results Among all women, dysfunctional uterine bleeding （DUB） was the most common seen, accounting for 50. 56% （360/712）of the total, of which, anovulatory DUB was prominent （286/360, 79.44 % ）. There was age-dependent increasing tendency in pathologic types of endometrlal hyperplasia from simple hyperplasia, complex complicated byperplasia, atypical byperplasia, to endometrlal carcinoma in order. Endometrial carcinoma was centrally seen in the postmenopausal period. Conclusion The incidence of abnormal uterine bleeding of patients in the two groups is similar. Diagnostic curettage, and endometrial pathological examination and comprehensive analysis of pathological changes are all crucial for diagnosis, differentiated diagnosis and reasonable treatment of abnormal uterine bleeding.

关 键 词：子宫异常出血 功能性子宫出血 病理 诊断性刮宫 

分 类 号：R711.74[医药卫生—妇产科学] R711.52[医药卫生—临床医学]