绝经过渡期子宫不规则出血的相关性研究

目的:探讨绝经过渡期子宫不规则出血的原因及诊断措施。方法:回顾性总结了2001年1月~2003年12月的36个月内,因绝经前子宫不规则出血及月经紊乱而行诊断性刮宫(诊刮)术的1 282例患者,将其临床表现及诊刮所得病理结果进行分析。结果:1 282例中,功能失调性子宫出血(功血)占50.62%(649例),子宫内膜良性病变占16.69%(214例),炎症性疾病占10.84%(139例),节育环位置异常占7.64%(98例),妊娠相关疾病占6.94%(89例),药物治疗占5.23%(67例),恶性病变占0.39%(5例),不典型性增生占1.64%(21例)。病理结果:刮出物中仅见黏液、凝血块等占0.31%(4例),子宫内膜为增殖期内膜占55.54%(712例),分泌期占6.08%(78例),混合型占9.82%(126例),萎缩型占3.20%(41例);炎症并呈息肉状增长占16.07(206例);妊娠物(蜕膜及滋养细胞)占6.94%(89例);不典型增生过长占1.64%(21例);恶性病变占0.39%(5例)。结论:绝经过渡期子宫不规则出血的主要原因为功血、子宫内膜良性病变、炎症性疾病、宫内节育器、妊娠相关疾病等。对于绝经过渡期子宫不规则出血,阴道超声(TVS)是首选的,而诊刮术依然是必行的检查手段。

Correlative study on abnormal uterine bleeding of women during menopausal transition period

Objective:To explore the causes and diagnosis of abnormal uterine bleeding of women during menopausal transition period.Methods:1 282 patients underwent diagnostic curettage because of abnormal uterine bleeding and menstrual disorder before menopause from January 2001 to December 2003 were summarized retrospectively,their clinical manifestations and pathological results of diagnostic curettage were analyzed.Results:Among 1 282 patients,the proportions of dysfunctional uterine bleeding,endometrial benign lesions,inflammatory diseases,abnormal location of intrauterine device(IUD),pregnancy related diseases,drug treatment,malignant lesions,atypical hyperplasia were 50.62%(649 patients),16.69%(214 patients),10.84%(139 patients),7.64%(98 patients),6.94%(89 patients),5.23%(67 patients),0.39%(5 patients) and 1.64%(21 patients),respectively.Pathological results: the proportions of mucus and sludged blood,endometrium of proliferative phase,secretory phase,mixed type,atrophic type,inflammation of polypoid hyperplasia,decidua and trophoblast,atypical hyperplasia,malignant diseases were 0.31%(4 patients),55.54%(712 patients),6.08%(78 patients),9.82%(126 patients),3.20%(41 patients),16.07%(206 patients),6.94%(89 patients),1.64%(21 patients) and 0.39%(5 patients),respectively.Conclusion:The main causes of abnormal uterine bleeding during menopausal transition period include dysfunctional uterine bleeding,endometrial benign lesions,inflammatory diseases,IUD and pregnancy related diseases,for the patients with abnormal uterine bleeding during menopausal transition period,transvaginal sonography is the primary examination method,but diagnostic curettage is a necessary examination method.