摘要
目的探讨不同年龄段异常子宫出血患者的病因构成。方法选取2018年3月至2020年9月期间就诊于相城区第二人民医院的320例异常子宫出血患者。按照患者的年龄段进行分组,包括青春期(n=20)、育龄期(n=110)、围绝经期(n=190)。患者均行全身检查、妇科检查(无性生活者肛查)、血常规检查、凝血功能检查、超声检查。部分患者肝肾功能、生殖内分泌测定以及促甲状腺激素检查(TSH)检查,必要者行诊刮术或者宫腔镜检查,分析不同年龄段的患者发生异常子宫出血的病因及分布情况。结果青春期与育龄期的患者发生非结构性因素显著高于结构性因素,差异有统计学意义(P<0.05);围绝经期女性发生异常子宫出血的结构性因素显著高于非结构性因素,差异有统计学意义(P<0.05)。其中,青春期患者发生异常子宫出血的主要因素为排卵障碍;育龄期患者多因子宫局部异常;围绝经期多因子宫内膜息肉。结论引发异常子宫出血的因素会逐渐从排卵障碍等非结构性因素转变成结构性因素,在临床诊断的过程中应结合患者的年龄、病史以及各项检查结果以及病理诊断结果进行对症治疗。
Objective To explore the etiology of abnormal uterine bleeding in patients of different ages.Methods A total of 320 patients with abnormal uterine bleeding who visited the Second People's Hospital of Xiangcheng District from March 2018 to September 2020 were selected.Patients were grouped according to their age,including puberty(n=20),reproductive age(n=110),and perimenopause(n=190).All patients underwent systemic examination,gynecological examination(anal examination of asexual living persons),blood routine examination,coagulation function test,and ultrasound.In some patients,liver and renal function,reproductive endocrine assays as well as TSH testing,and if necessary,curettage or hysteroscopy were performed to analyze the etiology and distribution of abnormal uterine bleeding in patients of different ages.Results The occurrence of non-structural factors in adolescent and childbearing age patients was significantly higher than that of structural factors,and the contrast was significant(P<0.05);the structural factors of abnormal uterine bleeding in perimenopausal women were significantly higher than nonstructural factors,and the contrast was significant(P<0.05).Among them,the main factor for abnormal uterine bleeding in adolescent patients is ovulation disorders;multifactorial uterine abnormalities in patients of childbearing age;perimenopausal multifactorial endometrial polyps.Conclusion The factors that cause abnormal endometrial hemorrhage will gradually change from non-structural factors such as ovulation disorders to structural factors.In the process of clinical diagnosis,the pathological diagnosis results should be obtained and symptomatic treatment should be combined with the patient’s age,medical history and various examination results.
作者
朱春芹
ZHU Chunqin(The Second People's Hospital of Xiangcheng District,Suzhou,Jiangsu 215143,China)
出处
《大医生》
2020年第24期110-112,共3页
Doctor
关键词
青春期
育龄期
围绝经期
异常子宫出血
病因构成
puberty
childbearing age
perimenopausal period
abnormal uterine bleeding
etiology
