肥胖妇女绝经后无症状子宫内膜增厚患者临床病理分析  

Clinicopathological analysis of asymptomatic endometrial thickening in obesity postmenopausal women

作　　者：王海波[1] 赵金荣[1] 逯彩虹[1] 高丽彩[1] 张爱群[1] 付红霞[2] 马广俊[3] 

机构地区：[1]解放军第260医院妇产科,河北石家庄050041 [2]解放军第260医院病理科,河北石家庄050041 [3]解放军第260医院医教处,河北石家庄050041

出　　处：《中国现代医学杂志》2015年第31期88-91,共4页China Journal of Modern Medicine

基　　金：河北省2015年度医学科学研究重点课题资助(No:20150369)

摘　　要：目的 探讨肥胖妇女绝经后经阴道超声检查发现无症状子宫内膜增厚患者病理情况。方法 回顾分析2008年1月-2013年11月在该院妇产科就诊的绝经后阴道超声提示子宫内膜增厚而无症状的肥胖患者288例（观察组）的临床资料,288例均行宫腔镜检查,取组织进行病理检查;并与同期正常体重组经阴道超声提示子宫内膜增厚而无症状的患者399例（对照组）进行比较。结果 肥胖组子宫内膜增厚患者良性病理多数为子宫内膜息肉（51.4%）,子宫内膜复杂性增生（15.6%）,子宫内膜单纯性增生（10.8%）及子宫黏膜下小肌瘤（6.3%）。18例诊断为子宫内膜癌,占6.3%,13例子宫内膜不典型增生,占4.5%;对照组病理结果排序依次为子宫内膜息肉（53.4%）、内膜单纯性增生（15.3%）、复杂性增生（10.0%）和黏膜下小肌瘤（7.8%）。子宫内膜癌占2.8%,不典型增生占1.8%。两组病变构成比差异有统计学意义（χ2=16.4,〈0.05）。内膜厚度在7-10 mm,两组在复杂性增生、不典型增生及内膜癌构成比有明显的统计学意义（〈0.05）。内膜〉10 mm后两组在复杂性增生、不典型增生及内膜癌构成比方面差异无显著统计学意义（〉0.05）。结论 肥胖患者绝经后无症状子宫内膜增厚≥5 mm者,宫腔镜检查是首选检查,检查的同时应行定点病理活检,对病理检查阴性者亦应加强随访。[ Objective ] To explore the pathological conditions of asymptomatic endometrial thickening examined by transvaginal ultrasound in obesity postmenopausal women. [Methods] From January 2008 to November 2013, clinical data of 288 cases （observation group） asymptomatic endometrial thickening after menopause patients in our hospital were taken vaginal ultrasound examination, they also underwent hysteroscopy and pathological examination; compared with 399 cases （control group） of asymptomatic endometrial thickening patients in normal weight. [ Results] Endometrial polyps （51.4%）, complexity of endometrial hyperplasia （15.6%）, endometrial simplex hyperplasia （10.8%） and small submucosal myoma of uterus （6.3%） were found in observation group. 18 cases were diagnosed endometrial cancer （6.3%）, 13 cases of atypical hyperplasia of endometrium （4.5%）; while in control group, endometrial polyps （53.4%）, endometrial simplex hyperplasia （15.3%）, complexity of endometrial hyperplasia （10.0%） and small submucous myoma of uterus （7.8%）, endometrial cancer （2.8%）, atypical hyperplasia （1.8%）. The difference was statistically significant （χ^2=16.4, P 〈 0.05）. Endometrial thickness between 7 to 10 mm, constituent ratio of complexity hyperplasia, uterine endometrial carcinoma and atypical hyperplasia between the two groups have statistical significance （P 〈 0.05）. Hyperplasia of endometrium 〉 10 ram, constituent ratio of complexity, atypical hyperplasia and endometrial carcinoma between the two groups have no statistical significance （P 〉 0.05）. [ Conclusion ] Hys- teroscopy may take as the first check choice for obesity patients with asymptomatic postmenopausal endometrial thickening ≥ 5 mm and sentinel biopsy should be performed at the same time, follow-up also should strengthen on biopsy negative patients.

关 键 词：肥胖妇女 绝经 子宫内膜 病理学 宫腔镜 

分 类 号：R711.32[医药卫生—妇产科学]