女性绝经后阴道出血病变类型和相关因素研究  

Lesion type and related factors of vaginal bleeding after menopause

作　　者：张娇燕 陈玉梅[2] 童芳 甘春燕 邓世昌 黄新苑 

机构地区：[1]深圳市龙华新区人民医院社管中心,广东深圳518109 [2]深圳市第八人民医院妇产科,广东深圳518000

出　　处：《中国性科学》2016年第10期52-54,共3页Chinese Journal of Human Sexuality

摘　　要：目的:探讨绝经后阴道出血临床原因与病理分析。方法:通过对2013年5月至2015年2月医院收治的120例绝经后阴道出血患者进行病理检查分析患者阴道出血病理分型,同时对引发患者绝经后阴道出血的临床危险因素进行单因素和多因素Logistic非条件回归分析,分析引发患者出血的临床原因。结果:统计120例绝经后阴道出血患者病理分型结果显示120例患者中有93例患者为炎性病变,其中有27例细菌性阴道炎占22.50%,39例老年性阴道炎占32.50%,子宫内膜炎12例占10.00%,9例盆腔炎占7.50%,6例卵巢囊肿占5.00%;恶性病变患者有27例,包括13例子宫内膜癌占10.83%,宫颈癌7例占5.83%,平滑肌肉瘤4例占3.33%,间质瘤2例占1.67%,卵巢癌1例占0.83%;对影响患者绝经后阴道出血的临床危险因素进行单因素和多因素Logistic回归分析,结果显示患者年龄过大、绝经时间较长及子宫内膜过厚均为单独影响患者阴道出血的危险因素(P<0.05)。结论:临床绝经后阴道出血患者多以炎性病变为出血原因,患者年龄较大、绝经时间较长、子宫内膜较厚均会引发患者阴道出血。Objectives： To investigate the clinical and pathological reasons of vaginal bleeding after menopause. Methods： 120 patients with vaginal bleeding from May 2013 to February 2015 received pathology analysis to decide the pathological type. Single factor and multivariate unconditional logistic regression analysis was conducted on risk factors to analyze the clinical causes of bleeding. Results： 93 patients had inflammatory lesions,including 27 cases of bacterial vaginosis（ 22. 50%）,39 cases of senile vaginitis（ 32. 50%）,12 cases of endometritis（ 10%）,9 cases of pelvic inflammatory disease（ 7. 50%） and 6 cases of ovarian cyst（ 5%）. 27 patients were with malignant lesions,including 13 cases of endometrial cancer（ 10. 83%）,7 cases of cervical cancer（ 5. 83%）,4 cases of leiomyosarcoma（ 3. 33%）,2 cases of stromal tumor（ 1. 67%） and 1 case of ovarian cancer（ 0. 83%）. According to the logistic regression analysis,old age,long time of menopause and thick endometrium were all risk factors of vaginal bleeding（ P〈 0. 05）. Conclusion： The clinical postmenopausal bleeding is mainly due to multiple lesions with inflammatory,and old age,long time of menopause and thick endometrium all lead to vaginal bleeding.

关 键 词：绝经 阴道出血 临床原因 病理分析 

分 类 号：R711.51[医药卫生—妇产科学]