绝经后异常子宫出血患者的临床与病理分析

目的 探讨绝经后异常子宫出血的最佳临床诊治方法。方法 回顾性分析自2019年1月31日至2020年1月31日收治的绝经后异常子宫出血的62例患者,行经阴道超声和宫腔镜检查并根据是否需要进行手术及病理组织学检查。 结果 62例患者中宫腔镜镜下诊断正常子宫内膜(包括萎缩性内膜和增殖期内膜)13例,子宫内膜厚度均≤10 mm;子宫腔内良性病变共41例,在子宫内膜厚度<5 mm、5~10 mm及>10 mm各区间发病率接近;子宫内膜非典型增生和子宫内膜癌共8例,随着子宫内膜厚度的增加,子宫内膜恶性病变的发病率逐渐增高;62例患者的宫腔镜镜下诊断与术后病理检查结果的符合率为91.9%。结论 对于绝经后异常子宫出血的患者,建议行宫腔镜检查及直视下活检,以对子宫腔内病变作出早期诊断与治疗。

Clinical and pathological analysis of postmenopausal women with abnormal uterine bleeding

Objective To explore the best clinical diagnosis and treatment method of abnormal uterine bleeding after menopause. Methods Sixty two postmenopausal women with abnormal uterine bleeding were analyzed retrospectively,who underwent transvaginal ultrasound, hysteroscopy and / or surgery and histopathology from January 31, 2019 to January 31, 2020. Results In the 62 women diagnosed by hysteroscopy, there were normal endometrium (including atrophic endometrium and proliferative endometrium) in 13 cases, with endometrial thickness less than 10 mm. There were 41 cases of benign uterine lesions, and in the endometrial thickness of <5 mm,5-10 mm and >10 mm, the incidence rate was similar. Endometrial atypical hyperplasia and endometrial carcinoma were 8 cases. With the increase of endometrial thickness, the incidence rate increased gradually. The coincidence rate between hysteroscopic diagnosis and postoperative pathological examination was 91.9%. Conclusion For the women with abnormal uterine bleeding after menopause, hysteroscopy and direct vision biopsy are recommended to make early diagnosis and treatment for intrauterine lesions.