绝经后无症状子宫内膜增厚妇女256例临床分析

目的:探讨绝经后无症状子宫内膜增厚的临床处理。方法:对256例绝经后无症状、经阴道超声检查子宫内膜厚度≥5 mm妇女行孕激素试验(PCT)、宫腔镜检查或治疗、诊断性刮宫及病理检查。结果:171例妇女PCT阳性,活性内膜167例(97.66%),其中单纯性增生9例,复杂性增生5例,不典型性增生3例,子宫内膜癌1例,4者占总数的6.64%;85例PCT阴性,活性内膜19例(22.35%),无1例子宫内膜增殖症或子宫内膜癌,两组比较差异有统计学意义(P<0.05)。结论:绝经后无症状子宫内膜增厚妇女应行PCT检查,PCT阴性者可免于行诊断性刮宫,但应密切随访。

Clinical analysis on asymptomatic endometrial thickening of postmenopausal women in 256 cases

Objective:To explore the clinical therapy of asymptomatic endometrial thickening in postmenopausal women.Methods:256 cases of postmenopausal asymptomatic women whose thickness of endometrium≥5 mm diagnosed by transvaginal ultrasonography(TVS) were tested by progesterone challenge test(PCT),hysteroscopy and curettaged for pathological analysis.Results:171 cases were found positive PCT,167 cases(97.66%) had active endometrium(97.66%),including 9 cases of simple hyperplasia,5 cases of complex hyperplasia,3 cases were found atypical hyperplasia,1 case was found endometrial carcinoma,the above four factors occupied 6.64% of all cases;85 cases were found negative PCT,19 cases(22.35%) had active endometrium(P<0.05).Conclusion:Asymptomatic endometrial thickening of postmenopausal women should be tested by progesterone challenge test.Women whose PCT results are positive shouldn't be curettaged but should be followed up closely.