摘要
目的:探讨围绝经期子宫异常出血的原因和早期诊治子宫体恶性肿瘤。方法:结合B型超声、宫腔镜检查、诊断性刮宫和组织学活检等方法,对2451例子宫异常出血病例进行回顾性分析,并对其临床和病理资料进行研究。结果:异常子宫出血患者中围绝经期患者占52.6%,显著地高于生育期和绝经期(P<0.005)。围绝经期子宫异常出血病人患子宫内膜癌占3.1%,占子宫内膜癌总例数的29.6%,比生育期明显增高(P≤0.005)。在围绝经期子宫内膜癌患者中,22.6%的病例为非腺癌,中分化腺癌(G2)29.1%和8.3%的低分化腺癌(G3);非腺癌发生率明显高于生育期,与绝经期相近。中、低度分化腺癌的发生率显著高于生育期,但低于绝经期。结论:异常子宫出血主要发生在围绝经期。子宫内膜增生是该期异常子宫出血的主要原因。围绝经期子宫内膜癌发生率呈增高趋势,并开始出现预后不良的病理类型。明确围绝经期异常子宫出血的病因是早期发现子宫体恶性肿瘤的关键。
Objective In order to research the cause of abnormal uterine bleeding in perimenopausal women. Method 2451 cases with abnormal uterine bleeding were analyzed by dilation and curettage of uterus or surgery combining with Type B ultrasonography and hysteroscopy, and the clinic and pathologic characteristics of endometrium were analyzed simultaneously. Results Of 2 451 cases with abnormal uterine bleeding, 52.6% were perimenopausal women,which was higher than those in child-bearing period and postmenopause （P〈0.005）. There were 40 cases （3.1%） of endometrial carcinóma in perimenopausal women with abnormal uterine bleeding, and it is 29.6% of patients with endometrial carcinoma in all three physiologic periods. The 29.6% constructive rate of endometrial carcinoma in perimenopause is higher than 7.4% in child-bearing period （P〈0.005）. In 31 perimenopausal women with endometrial carcinoma undergoing surgery, 22.6% of cases were non- adenocarcinoma. The incidence of non- adenocarcinoma is obviously higher in perimenopause than that in child-bearing period and is similar with that in postmenopause. 29.7% （/24） is graded as mid-differentiation （G2） and 8.3% （2/24） as low -differentiation （G3）. The ratio of adenocarcinoma with middle and low differentiation is markedly higher in perimenopause than that in child-bearing period, but lower than that in postmenopause. Conclusion Abnormal uterine bleeding occurred mainly in perimenopausal period. Endometrial hyperplasia is the main cause of abnormal uterine bleeding m perirnenopausal period. It is obvious that trend increasing endometrial carcinogenesis was gradually enhanced during perirnenopause, and poor prognosis pathological types of endometrial carcinoma could be found in this period. To clear the cause of abnormal uterine bleeding in perimenopausal period is an important issue in early detecting malignant tumor of uterine.
出处
《吉林医学》
CAS
2005年第8期814-817,共4页
Jilin Medical Journal
关键词
围绝经期
子宫内膜癌
异常子宫出血
内膜增生
Perimenopause
Abnormal uterurine bleeding
Endometrial carcinoma
Endometrial hyperplasia
