绝经后子宫出血病因研究.docVIP

绝经后子宫出血病因研究[摘要] 目的：探讨绝经后子宫出血（PMB）的病因分类和特点。方法：回顾性分析本院近3年来176例PMB患者的资料，根据病理检查的结果确定病因，分析其特点。结果：176例PMB患者中非器质性病变46例（26.1%）；良性病变79例（44.9%）；恶性病变51例（29.0%）。50～70岁组以良性病变居多，而70～80岁组则以恶性病变居多（χ2=19.962，P=0.001）。同时，非器质性病变平均年龄最低，而恶性病变的平均年龄最高（F=8.774，P=0.003）。恶性PMB的危险因素主要有患者的年龄、绝经年限、出血距初诊时间及子宫深度4种。结论：绝经后子宫出血病因以良性病变为主，但随着年龄的增加，恶性疾病发生的机会增高，应引起注意。 [关键词] 子宫出血；绝经；病因；病理 [中图分类号] R711 [文献标识码]A[文章编号]1674-4721（2011）03（b）-014-02 Etiology of postmenopausal bleeding WAN Fen, YANG Sailong Maternal and Child Health Hospital of Yueyang City in Hunan Province, Yueyang 414000, China [Abstract] Objective: To investigate the etiology for postmenopausal bleeding (PMB). Methods: A retrospective analyzed of 176 patients with PMB 3 years in our hospital was used in this study. According to the results of pathological examination, we analyzed its etiology. Results: In 176 patients with PMB, 46 patients (26.1%) had no organic disease; 79 patients (44.9%) had benign lesions; 51 patients (29.0%) had m alignant lesions. 50-70 age group were mostly benign lesions, while the 70-80 age group, mostly m alignant disease (χ2=19.962, P=0.001). Meanwhile, the average age of patients with non-organic disease were lower, and the average age of patients with m alignant lesions were higher (F=8.774, P=0.003). Risk factors for m alignant PMB were patient′s age, years since menopause, uterine bleeding time and the depth of uterine. Conclusion: The cause of postmenopausal bleeding is benign lesions. However, with increasing age, the chance of m alignant disease increased, which should pay more attention. [Key words] Uterine bleeding; Menopause; Etiology; Pathology 绝经后出血（post-menopausal bleeding，PMB）是指绝经后1年以上的阴道出血，是老年妇女常见症状之一。随着老年医学的发展，PMB已成为现代围绝经医学的重要研究课题[1-2]。本研究回顾性分析本院近3年来 PMB患者的资料，探讨其病因分类和特点，为临床诊治提供参考。 1 资料与方法 1.1 一般资料 回顾性分析2007年1月～2010年10月于本院治疗的176例PMB患者的资料。排除阴道、宫颈、尿道和肛门出血，PMB诊断明确。176例患者年龄51～78岁，平均（62.6±6.8）岁。绝经期1～21年，平均（5.6±4.7）年。出血病史4～50 d，或者反复不规则出血2～6个月。主要临床表现为阴道出血、血性分泌物、性生活后出血等。