绝经后宫腔占位性疾病437例临床分析  

Clinical analysis of 437 patients with space-occupying lesion in postmenopausal women

作　　者：韩亚琴 高蜀君[2] Han Yaqin Gao Shujun(Department of Gynecology,the Sixth People＇s Hospital of Nantong,Jiangsu, 226011 ,China Center for Diagnosis and Treatment of Cervical Disease ,Obstetrical and Gynecological Hospital of Fudan University,Shanghai,200011 ,China)

机构地区：[1]南通市第六人民医院妇科,江苏226011 [2]复旦大学附属妇产科医院宫颈疾病诊疗中心,上海200011

出　　处：《现代医药卫生》2017年第9期1316-1318,共3页Journal of Modern Medicine & Health

摘　　要：目的分析绝经后妇女宫腔占位性病变的临床特征及其与病理特点的相关性,探讨宫腔镜诊治策略。方法收集2015年4~9月在复旦大学附属妇产科医院因宫腔占位性病变而行宫腔镜诊治的437例绝经后妇女的临床资料进行回顾性分析。结果 437例患者平均年龄(60.56±4.08)岁,平均绝经时间(9.69±5.74)年。宫腔镜检查平均占位大小(13.32±6.32)mm并切除,超声提示占位大小最大径线(12.10±7.26)mm,术后病理提示宫腔占位良性病变(良性病变组)占96.11%(420/437),恶性及内膜癌前病变(恶性病变组)占3.89%(17/437)。其中子宫内膜息肉占82.84%(362/437),子宫黏膜下肌瘤占7.09%(31/437),子宫内膜增生反应占4.12%(18/437),宫腔粘连占0.46%(2/437),子宫内膜复杂不典型增生占1.60%(7/437),子宫内膜腺癌占3.20%(14/437),子宫癌肉瘤占0.46%(2/437),子宫内膜间质肿瘤占0.23%(1/437)。良性病变、恶性病变组患者的年龄、绝经时间及阴道排液发生率比较,差异均无统计学意义(P>0.05),而良性病变组阴道出血发生率明显低于恶性病变组,差异有统计学意义(P<0.01)。良性病变组超声检查及宫腔镜术中占位大小(最大径线值)与恶性病变组比较,差异均有统计学意义(P<0.05),两组超声检查测量的占位大小与宫腔镜术中直视测量的结果比较,差异均无统计学意义(P>0.05)。结论绝经后阴道出血、占位径线大于13.5 mm为宫腔恶性占位性病变的高危因素,应及时给予相应的诊断和治疗。Objective To analyze the clinical factor of space-occupying lesion in postmenopausal women and its correlation with pathological feature,in order to explore the diagnostic strategy of hysteroscopy.Methods Clinical data of 437 postmenopausal women with space-occupying lesion underwent hysteroscopic treatment in Obstetrical and Gynecological Hospital of Fudan University from April to September 2015 were collected and analyzed retrospectively.Results The average age of the 437 patients was（60.56 ±4.08） years old,and the mean time of menopause was（9.69 ±5.74） years.The hysteroscopy examination showed that the average size of occupying leision was（13.32±6.32） cm then lesions were cut off.The ultrasound examination showed that the maximum diameter of the lesions was（12.10±7.26） mm.The postoperative pathology suggested that 96.11%（420/437）patients was with benign space-occupying lesion（benign group） and 3.89%（17/437） patients was with malignant or precancerous lesions（malignant group）.The diagnostic results showed that endometrial polyps accounted for 82.84%（362/437）,submucous myoma accounted for 7.09%（31/437）,endometrial hyperplasia 4.12%（18/437）,intrauterine adhesion 0.46%（2/437）,endometrial hyperplasia with atypia 1.60%（7/437）,endometrial carcinoma 3.20%（14/437）,uterine carcinosarcoma 0.46%（2/437）,endometrial stromal tumor 0.23%（1/437）.The incidence of age of patient,time of menopause and virginal discharge between the benign group and the malignant group had no statistically significant difference（P〉0.05）,while the incidence rate of colporrhagia in the benign group was obviously lower than that in malignant group with statistically significant difference（P〈0.01）.The difference on maximum diameter detected by ultrasonography and hysteroscopy in the benign group and the malignant group had statisti-cal significance（P〈0.05）,but comparing with the hysteroscopy,the difference on the lesion diameters detected by ultrasonography between t

关 键 词：绝经后期 子宫疾病 子宫内膜肿瘤 子宫息肉 宫腔镜 

分 类 号：R711.32[医药卫生—妇产科学]