围绝经期无症状取环女性的子宫内膜病理学特征与意义  

The pathological characteristics and significance of endometrial in asymptomatic women with peri-menopause

作　　者：周爱枝[1] 任青[2] 曹薇薇[1] 王梅 叶文凤 沈新娣 Zhou Aizhi;Ren Qing;Cao Weiwei;Wang Mei;Ye Wenfeng;Shen Xindi(Department of Obstetrics and Gynecology,Shanghai Pudong New Area People's Hospital,Shanghai 201299,China;Department of Obstetrics and Gynecology,The Ninth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 20001l,China;Department of Arts and Science,Shanghai Health Medical College,Shanghai 201318,China)

机构地区：[1]上海市浦东新区人民医院妇产科,上海201299 [2]上海交通大学附属第九人民医院妇产科,上海200011 [3]上海健康医学院文理教学部,上海201318

出　　处：《实用妇科内分泌电子杂志》2023年第30期4-8,共5页Electronic Journal of Practical Gynecological Endocrinology

基　　金：上海市浦东新区卫生健康委员会妇科重点学科(编号PWZxk2022-28)。

摘　　要：目的通过对围绝经期无症状要求取环的女性,子宫内膜厚度≥5mm的病理学结果进行统计分析,分析此人群子宫内膜病理特点,探讨围绝经期无症状女性子宫内膜厚度的正常值及此类人群取环时是否需要同时行诊刮术。方法收集要求取出子宫内节育器同时行诊刮术、无明显症状、子宫内膜厚度≥5mm患者,观察其子宫内膜厚度及病理学特点。结果本研究共收集符合入组条件的病例63例,因惧怕子宫内膜癌或癌前病变,均在取出子宫内节育器的同时主动要求行诊刮术。患者年龄43~57岁,平均(52.1±1.6)岁;停经时长3~12个月,平均(7.6±1.5)个月;子宫内膜厚度5~11mm,平均(5.6±1.8)mm。所有患者均已生育,并放置宫内节育器避孕。子宫内膜组织病理学特征:63例患者子宫内膜组织病理学主要表现为:少许破碎子宫内膜及颈管黏膜36例(57.1%),增生期子宫内膜17例(27.0%),宫腔黏液、脱水后未见组织相7例(11.1%)。其他病理类型:分泌期子宫内膜1例(1.6%),停经时长3个月,子宫内膜厚度为6mm;子宫内膜息肉1例(1.6%),停经时长3个月,子宫内膜厚度为5mm;宫腔炎性渗出物1例(1.6%),停经时长6个月,子宫内膜厚度为6mm。各病理类型与患者年龄及子宫内膜厚度之间比较,差异无统计学意义(P>0.05)。各病理类型的停经时长比较差异有统计学意义(P<0.05),除3例个案外,其中停经时间较短的病理类型为增生期样宫内膜(P<0.05)。结论围绝经期无症状患者子宫内膜厚度在5~11mm均为良性病变,可考虑先取环后复查子宫内膜厚度,必要时再行诊刮术。Objective Through statistical analysis of the pathological results of endometrial≥5 mm in asymptomatic perimenopausal women who requested ring extraction,the pathological characteristics of endometrial in this population were analyzed,and the normal value of endometrial thickness in asymptomatic women in perimenopausal women and whether it is necessary to simultaneously diagnose and scrape the ring in this population were discussed.Methods It was required to remove the IUD and perform curettage at the same time.Patients with no obvious symptoms and endometrial thickness≥5 mm were observed to have endometrial thickness and pathological characteristics.Results A total of 63 patients eligible for inclusion were collected in this study.Due to the fear of endometrial cancer or precancerous lesions,all of them voluntarily requested curettage at the same time of removing the IUD.Patients ranged in age from 43 to 57 years,with an average age of(52.1±1.6)years.The duration of menopause ranged from 3 to 12 months,with an average of(7.6±1.5)months.The endometrial thickness was 5~11 mm,with an average of(5.6±1.8)mm.All patients had given birth and had an IUD placed to prevent pregnancy.Endometrial histopathology:The main manifestations of the 63 patients were:a little broken endometrial membrane and cervical duct mucosa in 36 cases(57.1%),proliferative phase endometrial membrane in 17 cases(27.0%),and no tissue phase after uterine mucus and dehydration in 7 cases(11.1%).Other pathological types:secretory endometrium in 1 case(1.6%),duration of menopause was 3 months,endometrial thickness was 6 mm;Endometrial polyp was found in 1 case(1.6%)with a length of 3 months and endometrial thickness of 5 mm.Uterine inflammatory exudate was found in 1 case(1.6%)with a duration of 6 months and endometrial thickness of 6 mm.There was no significant difference between pathological types,age and endometrial thickness(P>0.05).There were significant differences in the duration of menstruation among different pathologic types(P<0.05),e

关 键 词：围绝经期 子宫内节育器 子宫内膜厚度 子宫内膜病理 

分 类 号：R737.33[医药卫生—肿瘤]