绝经后反复阴道流血病理类型探讨  

The Study of Pathological Types of Recurrent Postmenopausal Bleeding

作　　者：杨岑[1] 蒋芳[1] 郭俊梅 李源[1] 钱秋红[1] 张蕾[1] 姬萌霞[1] 史宏晖[1] 

机构地区：[1]中国医学科学院北京协和医院,北京100730 [2]河北省张家口市宣化钢铁公司职工医院,河北张家口075100

出　　处：《实用妇产科杂志》2015年第4期285-287,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨首次绝经后阴道流血(PMB)子宫内膜病理检查未提示癌变及癌前病变的患者,发生绝经后反复阴道流血(RPMB)的病理诊断结果。方法:回顾性分析1998年1月1日至2013年12月31日期间因RPMB就诊于北京协和医院患者的临床病理资料。结果:北京协和医院15年间因PMB就诊行子宫内膜活检的患者918例中,有RPMB患者112例,首次子宫内膜活检病理检查未提示癌变及癌前病变。RPMB患者中诊断为子宫内膜癌的发生率为8.04%(9/112),与PMB患者的子宫内膜癌发生率7.95%(73/918)比较,差异无统计学意义(P>0.05)。有7例(12.50%)患者在接受全子宫+双侧附件切除术后诊断为卵巢性索间质肿瘤。结论:首次子宫内膜活检病理未提示癌变及癌前病变的RPMB患者子宫内膜癌的风险未增加。反复绝经后阴道流血患者应警惕卵巢性索间质肿瘤。Objective：To determine the final pathological diagnosis in patients presenting with recurrent postm- enopausal bleeding（RPMB） after initial negative investigations. Methods： The clinical manifestations and patho- logical features of all patients presenting with recurrent PMB between 1 January 1998 and 31 December 2013 were retrospectively studied in Peking Union Medical College Hospital. Results：A total of 918 women with PMB were collected over a period of 15 years, among which 112 were with RPMB. The prevalence of endometrial canc- er in women presenting with recurrent PMB after initial negative investigations was 8.04% （9/112） ;The preva- lence of endometrial cancer in women presenting for the first time with PMB was 7. 95% （73/918） ,there was no significant difference on the incidence between the former two condicitons （ P 〉 0. 05）. 7 patients （ 12.50% ） were diagnosed as ovarian sex-cord stomal tumor after hysterectomy and bilateral sapingoophorectomy. Conclusions： Women with recurrent PMB after initial negative investigations are no more likely to have endometrial cancer. Pa- tients presenting with recurrent postmenopausal bleeding（PMB） after initial negative investigation should be alert to ovarian sex-cord stomal tumor.

关 键 词：绝经后反复阴道流血 子宫内膜癌 经阴道超声 子宫内膜活检 绝经后阴道流血 

分 类 号：R711.51[医药卫生—妇产科学]