366例围绝经期和绝经后异常子宫出血病理分析  

Analysis of histopathological results in 366 women with peri- menopausal post- menopausal abnormal uterine bleeding

作　　者：王丽君[1] 胡晨[1] 刘天娇[1] 吴江平[1] 

机构地区：[1]南京医科大学附属南京妇幼保健院妇女保健科,江苏南京210004

出　　处：《中国计划生育和妇产科》2015年第4期40-42,共3页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的 探讨围绝经期及绝经后异常子宫出血的病因及相关因素。方法 对2013年南京医科大学附属南京妇幼保健院366例围绝经期及绝经后异常子宫出血病例的临床资料进行回顾性分析。结果 366例的病理诊断中,器质性病变50例（13.66%）,功能性病变145例（39.62%）,正常子宫内膜171例（46.72%）。40~〈45岁及45~〈50岁年龄组人数最多,占总人数的70.49%。40~〈45岁组常见的病理类型依次是增生期子宫内膜、单纯型增生和分泌期内膜;45~〈50岁、50~〈55岁组常见的病理类型依次是单纯型增生、增生期内膜和萎缩型内膜;55~〈60岁、≥60岁常见病理类型依次是萎缩型内膜、子宫内膜癌。随着年龄增大,功能性病变和正常子宫内膜在不同年龄组的构成比逐渐减小,器质性病变在不同年龄组的构成比逐渐增大（χ2=8.38,P﹤0.05）。结论 无排卵性功血是围绝经期子宫出血的主要原因,子宫内膜癌是绝经后子宫出血的主要原因。Objective To analyze the etiological factors of peri- menopausal and post- menopausal abnormal uterine bleeding.Methods The clinical data of 366 patients with peri- menopausal or post- menopausal abnormal uterine bleeding in Nanjing Medical University affiliated Nanjing Maternity and Child Health Hospital during 2013 were retrospectively analyzed. Results Among the pathological diagnosis of 366 patients,50（ 13. 66 %） cases were organic diseases,145（ 39. 62 %） cases were dysfunctional diseases,171（ 46. 72 %） cases were of normal endometrium. Maximum number（ 70. 49 %） of cases were from 40 ~ 45 and 45 ~ 50 age groups. In 40 ~ 45 age groups proliferative endometrium was the predominant histopathological pattern followed by simple hyperplasia and secretory endometrium. In 45 ~ 50 and 50 ~ 55 age groups simple hyperplasia was the predominant histopathological pattern followed by proliferative endometrium and atrophic endometrium. In 55 ~ 60 and ≥ 60 age groups atrophic endometrium was the predominant histopathological pattern followed by endometrial carcinoma. As the age increased,the composition of dysfunctional diseases and normal endometrium decreased,the composition of organic diseases increased（ χ2= 8. 38,P ﹤ 0. 05）. Conclusion Anovulatory dysfunctional uterine bleeding was the main cause of peri- menopausal uterine bleeding,and endometrial carcinoma was the main cause of post- menopausal uterine bleeding.

关 键 词：围绝经期 绝经后 异常子宫出血 病理诊断 

分 类 号：R711.52[医药卫生—妇产科学]