187例绝经后子宫内膜增厚老年女性临床病理分析  

Analysis of clinical and pathological features of 187 postmenopausal women with thickening endometrial

作　　者：崔颖[1] 马琳琳[1] 周丹[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》2012年第7期596-599,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨绝经后子宫内膜增厚妇女的临床及子宫内膜病理特点。方法2008年1月至2011年10月期间经阴道B超提示绝经后子宫内膜增厚的患者共187例，根据有无症状分为有症状组和无症状组，搜集其年龄；体重指数、初潮与绝经年龄、月经生育史、应用雌激素史、高血压及糖尿病史；所有患者均行官腔镜检查并取活检，结合病理结果，分析其临床结局及与之相关的影响因素。结果无症状组83例，有症状组104例，无症状组患者平均年龄（68．1±4．8）岁，明显高于有症状组（66．1士5．5）岁（t=3．89，P=0．046）。有症状组绝经时程（14．6±2．4）年，明显短于无症状组患者（16．5±2．9）年（t=4．12，P=0．039）；两组体重指数均偏高，有症状组（24．3±3．2）kg／m2，无症状组（23．3±2．6）kg／m2，但组间差异亦无统计学意义（t=3．79，P=0．052）。两组患者的既往病史差异无统计学意义。无症状组患者子宫内膜平均厚度为（7．2±1．4）mm，与有症状者（7．8士2．O）mm相比差异并无统计学意义（t=3．21，P=0．065）。无症状者发现子宫内膜样腺癌5例、子宫内膜不典型增生1例、子宫内膜息肉38例、黏膜下肌瘤25例、增殖期子宫内膜组织14例；有症状组发现子宫内膜样腺癌8例、子宫内膜间质肉瘤1例、子宫内膜浆乳癌4例、子宫内膜不典型增生5例，子宫内膜息肉47例，黏膜下肌瘤21例，官腔积脓2例，子宫内膜慢性炎8例、增殖期子宫内膜8例。结论绝经后子宫内膜增厚以良性病变为主，其中以子宫内膜息肉、黏膜下子宫肌瘤为主，但子宫内膜恶性肿瘤亦占一定比例，需引起高度重视。宫腔镜检查对于内膜病变的诊断和治疗具有创伤小、安全性高、特异性强的特点，宜作为绝经后子宫内膜增厚性疾病有效的诊疗工具之一。Objective To investigate the clinical and pathological features of postmenopausal women with thickening endometrial. Methods Totally 187 patients with postmenopausal endometrial thickening by transvaginal B-ultrasound were divided into symptomatic group （n=104） and asymptomatic group （n=83）. Their body mass index, age of menarche and menopause, history of menstruation and reproductive, application of estrogen, and hypertension and diabetes were collected. All the patients underwent hysteroscopy and biopsy procedures. Results There was no difference between two groups in body mass index[（24.3± 3.2） kg/mz vs. （23.3 ±2.6） kg/m2 , t = 3.79, P = 0. 052]. The postmenopausal time of symptomatic patients in the group was shorter than the asymptomatic [（14.6±2.4） years vs. （16. 5±2.9）years, t=4.12,P=0.039]. The patients in the asymptomatic group were older than the patients in the symptomatic group [（68.1 ±4.8） years vs. （66.1± 5.5） years, F=3.89, P = 0. 046 The average endometrial thickness of patients in the asymptomatic group showed no difference compared with patients in the symptomatic group [（7.2± 1.4） mm vs. （7.8±2.0） mm, F=3.21, P=0.065]. There were 5 cases of endometrial adenocarcinoma, 1 case of endometrial atypical hyperplasia, 38 cases of endometrial polyp, 25 cases of submucosal hysteromyoma, 14 cases of proliferative phase endometrium in the asymptomatic group while 8 cases of endometrial adenocarcinoma, 1 case of endometrial stromal sarcoma, 4 cases of endometrial serous papillary carcinoma, 5 cases of endometrial atypical hyperplasia, 47 cases of endometrial polyps, 21 cases of submucosal hysteromyoma, 2 cases of uterine empyema, 8 cases of chronic inflammation of the endometrium, 8 cases of proliferative phase endometrium in the symptomatic group, respectively. Conclusions Most of endometrial thickness in postmenopausal women are benign lesions, mainly including endornetrial polyps and subrnucous myoma, but endometrial cancer accounts for a certain percentag

关 键 词：绝经后期 子宫内膜增生 

分 类 号：R711.74[医药卫生—妇产科学]