绝经后无症状子宫内膜增厚患者临床病理分析  

Clinical and pathologic study on asymptomatic postmenopausal women with abnormal endometrial thickening

作　　者：方庆仙[1] 刘素萍[1] 诸葛听[1] 姚晓英[1] 

机构地区：[1]复旦大学附属妇产科医院,上海200011

出　　处：《生殖与避孕》2015年第10期698-702,708,共6页Reproduction and Contraception

摘　　要：目的:探讨绝经后妇女B超检查显示子宫内膜增厚而无症状者的子宫内膜病理变化。方法:对绝经后B超显示子宫内膜增厚无症状患者(无症状组)及同期绝经后B超显示子宫内膜增厚伴有阴道出血者(出血组)进行诊断性刮宫与病理检查结果比较。结果:无症状组子宫内膜增厚的86例患者中,非器质性病变44例(51.16%),良性病变42例(48.84%),无恶性及癌前病变;出血组子宫内膜增厚的79例中,非器质性病变48例(60.76%),良性病变17例(21.52%),恶性14例(17.72%)。无症状组随着年龄增大、绝经年限延长、内膜厚度增加,其良性病变呈上升趋势(P<0.05);出血组随着年龄增大、绝经年限延长、内膜厚度增加,其恶性病变呈上升趋势(P<0.05);其中无症状绝经后妇女B超示子宫内膜增厚者中内膜病变与内膜厚度和体质量指数(BMI)相关。结论:绝经后子宫内膜增厚不伴阴道出血时,多为良性病变,对于肥胖、内膜厚及绝经年龄较长患者更应重视。绝经后子宫内膜增厚伴有阴道出血时,恶性病变比例显著升高。Objective： To evaluate the relationship between abnormal endometrial thickening and endometrial diseases in asymptomatic postmenopausal women and to make strategy of treatment. Methods： Totally 86 asymptomatic postmenopausal women and 79 postmenopausal vaginal bleeding women with abnormal endometrial thickening in transvaginal ultrasound scanning were collected for fractional curettage of uterus and pathologic analysis. Results： Among 86 asymptomatic postmenopausal women with endometrial thickness ≥ 4 mm, there were 44 women with non-organic pathological change, 42 women with benign diseases, none with cancer; Among79 postmenopausal women of vaginal bleeding with endometrial thickness ≥ 4 mm, there were 48 women with non-organic pathological change, 17 women with benign diseases, and 14 women with cancer. The incidences of benign diseases increase with age, menopausal period, and endometrial thickness in asymptomatic postmenopausal women（P〈0.05）, however, the incidences of malignant diseases increased significantly in postmenopausal vaginal bleeding women（P〈0.05）. Among the asymptomatic postmenopausal women, endometrial diseases were correlated to the endometrial thickness and body mass index（BMI）. Conclusion： Most endometrial pathologies are benign diseases in asymptomatic postmenopausal women with abnormal endometrial thickening. We should focus on asymptomatic postmenopausal women with obese, endometrial thickening and older women. The incidences of malignant diseases increase significantly in the postmenopausal women of vaginal bleeding with endometrial thickening.

关 键 词：绝经 子宫出血 子宫内膜增厚 超声检查 病理学 

分 类 号：R711.74[医药卫生—妇产科学]