老年女性子宫腔积液临床分析  

Clinical analysis of hydrometra in the elderly women

作　　者：张巧[1] 李炜[1] 马琳琳[1] 赵学英[1] 

机构地区：[1]卫生部北京医院妇产科,100730

出　　处：《中华老年医学杂志》2011年第10期842-844,共3页Chinese Journal of Geriatrics

摘　　要：目的研究老年女性子宫腔积液的超声声像特征、临床特点和病理结果，探讨临床处理对策。方法应用阴道超声测量老年女性子宫腔积液患者子宫腔内积液深度，结合其子宫内膜厚度、子宫腔积液透声强度及有无内膜癌发病的高危因素，选择子宫腔镜内膜活检、分段诊断刮宫术及子宫腔细胞刷取术。将超声声像资料及子宫腔细胞学和内膜组织学检查的结果进行分析。结果72例患者中，子宫腔镜检查9例（12．5％）；分段诊断刮宫51例（70．8％）；子宫腔细胞学检查（子宫腔刷）加诊断性刮宫12例（16．7％）。病理诊断：子宫内膜癌7例（9．7％）；子宫内膜不典型增生2例（2．8％）；内膜良性病变6例（8．3％）；子宫腔积脓14例（19．4％）；正常内膜单纯积液43例（59．7％）。7例子宫内膜癌，2例子宫内膜不典型增生的9例患者中，有1种及1种以上内膜癌高危因素者8例（88．9％），明显高于正常内膜及内膜良性病变组（29／63，46．1％），两者比较差异有统计学意义（χ^2=4．20，P〈0．05）。结论老年女性是子宫内膜癌的高发人群，密切监测子宫内膜状态有利于尽早发现子宫内膜病变。老年女性对药物、手术的耐受性降低，治疗风险增大。阴道超声及子宫腔细胞学联合检查是一种较好的筛查子宫内膜病变和引流子宫腔积液的方法，可使有创性检查技术的使用率降低，减少诊断性刮宫。Objective To investigate ultrasonographic features, clinical and histopathologic characteristics of hydrometra in the elderly women. Methods Hysteroscopy endometrial biopsy, dilation and curettage （D＆C） and Tao Brush were selectively performed for the endometrial cytologic and histopathologic diagnosis according to the depth of the hydrometra investigated by transvaginal sonography, endometrial thickness and high-risk factors of carcinoma of endometrium in 72 elderly women with hydrometra . Results Among 72 elderly women with hydrometra, 9 cases （12.5%） were examined by hysteroscopy, 51 cases （70.8%） by D＆C and 12 cases （16.7%） by endometrial cytology along with D＆C. Histopathologic examination revealed that there were 7 （9.72%） cases with endometrial carcinoma, 2 cases （2.8%） with atypical endometrial hyperplasia, 6 cases （5.6%） with endometrial benign lesion, 14 cases（19.4 %）with pyometra and the other 43 cases （59.7 % ） with normal and simple hydrometra. Conclusions Transvaginal sonography in combination with endometrial cytology are beneficial for screening of endometrial disorders or for drainage of hydrometra in elderly women,decreasing invasive examinations such as D＆C.

关 键 词：超声检查 子宫内膜肿瘤 

分 类 号：R737.33[医药卫生—肿瘤]