宫腔镜检查对老年妇女异常阴道流血病因分析

 目的 探讨老年妇女宫腔镜手术的安全性和绝经后老年妇女（≥60岁）阴道流血的宫腔病因。 方法 以250例生育期妇女宫腔镜手术为对照，对250例老年妇女进行宫腔镜检查及病理诊断，以分析绝经后老年妇女阴道流血的宫腔病因。 结果 引起老年妇女阴道异常流血的宫腔病因为：子宫内膜息肉134例（53.60%）。子宫黏膜下肌瘤32例（12.80%），萎缩性子宫内膜炎43例（17.20%），子宫内膜癌14例（5.60%），子宫内膜不典型增生2例（0.80%），子宫内膜恶性中胚叶混合瘤1例（0.40%），子宫内膜复杂型增生过长2例（0.8%）。宫腔粘连8例（3.20%），环嵌顿，断裂14例（5.60%）。其中子宫内膜息肉、子宫内膜癌、及萎缩性子宫内膜炎发病率明显高于生育期妇女（P<0.01）；而子宫粘膜下肌瘤、宫腔粘连及功能性子宫出血病的发病率明显低于后者（P<0.05）。 结论 对于老年妇女可安全地进行宫腔镜检查；异常阴道流血病因可及时、准确诊断。

The etiological evaluation of abnormal vaginal bleeding in the post-menopausal women by way of hysteroscopy

Objective To evaluate the causes of abnormal vaginal bleeding in post-menopausal women by hysteroscopy. Methods The 250 cases of old-age women（≥60 yrs）were evaluated by hysteroscopy and pathological diagnosis for the causes of abnormal uterine bleeding, with 250 fertile women as control. Results It was found by hysteroscopy that the causes resulting in abnormal uterine bleeding in old-age women were as follow: endometrial polyps (53.60%), atrophic endometritis (17.80%), submucosal hysteromyoma (12.80%), endometrial cancer (5.60%), IUD incarceration (5.60%), intrauterine adhesion (3.20%), atypical hyperplasia (0.80%), complex endometrial hyperplasia (0.80%), endometria malignant mesoblast mixed tumor (0.40%) in which prevalence of endometrial polyps, atrophic endometritis, and endometrial cancer was higher significantly (P<0.01), and submucosal hysteromyoma, intrauterine adhesious and dysfunctional uterine bleeding was lower significantly than those of fertile women (P<0.05). Conclusion The causes of abnormal vaginal bleeding in post-menopausal women can be evaluated successfully by hysteroscopy .