子宫内膜增生和子宫内膜癌危险因素探讨  

Research for risk factor of endometial hyperplasia and endometrial cancer

作　　者：龚祝萍[1] 郝丽娟[1] 刘玉明[1] 刘畅[1] 

机构地区：[1]重庆市妇幼保健院,重庆400010

出　　处：《重庆医科大学学报》2010年第6期938-941,共4页Journal of Chongqing Medical University

摘　　要：目的:性激素治疗的参与,使我们重新认识围绝经期功血和绝经后阴道出血的治疗,寻找相关的危险因子,有利于优化治疗方案,减少不必要的诊刮。方法:选择绝经妇女45例和未绝经妇女182例,发病年龄、体质指数(Body mass index,BMI)、病程、经量多、高血压、糖尿病、激素替代(Hormone replacement therapy,HRT)、乳腺癌术后用药、甲状腺疾病、多囊卵巢综合征(Polycystic ovary syndrome,POS)、子宫内膜厚度作为观察指标,通过Logistic回归,研究其与异常子宫内膜的相关性。结果:行Logistic单因素和多因素回归,当未绝经妇女子宫内膜厚度≥7mm,与子宫内膜增生和子宫内膜癌有相关性,P=0.02;绝经后内膜厚度≥9mm时有相关性P<0.009,其余指标无明确的相关性。结论:绝经期妇女子宫内膜厚度<5mm,可以不做诊刮;未绝经妇女子宫内膜厚度<7mm,完全不需要诊刮,内膜厚度<9mm,可以先选择正规激素治疗,治疗无效再诊刮。大约1/3患者免除刮宫痛苦。Objective：The methods of hormone therapy prompt us to renewedly handle the perimenopausal dysfunctional uterine bleeding （DUB） and postmenopausal vaginal bleeding,search dangerous factors and optimize therapeutic schemes in order to reduce non-essential diagnostic curettage. Methods：45 perimenopausal women and 182 menopausal ones were choosed in our research and the following each index including the age of onset,body mass index,the course of diseases,excessive mentses,hypertension,diabetes, hormone replacement therapy,postoperative application of breast cancer,hypothyroidism,polycystic ovary syndrome or endometrial thickness was set as a variable to sdtudy the relationship between each variable and endometrial abnormity using Logistic regression analysis. Results：According to the Logistic regression analysis,there was a relevance between endometrial thickness and endometrial abnormity（endometrial hyperplasia endometrial cancer）when the endometrial thickness was equal to or more than 7 mm during the perimenopause period （P=0.02）,and so it was with the menopausal period when the endometrial thickness was equal to or more than 9 mm （P〈0.009）.Other factors had no significant influences on the endometrial abnormity. Conclusion：Diagnostic curettage is non-essential when endometrial thickness is less than 5 mm during the menopausal period,especially when it is less than 7 mm during the perimenopausal period.Once the endometrial thickness is less than 9 mm,regular hormone therapy can be firstly adopted. If the hormone therapy is ineffective,diagnostic curettage will be adopted. The study showed that about one third of patients were exempted from the pain caused by uterine curettage.

关 键 词：功血 子宫内膜厚度 围绝经期 绝经期 超声 病理 

分 类 号：R711.5[医药卫生—妇产科学]