【摘要】：目的:探討青海地區(qū)125例絕經(jīng)后子宮出血的原因,以及患者年齡、絕經(jīng)年限、子宮內(nèi)膜厚度、宮腔深度、出血持續(xù)時間等與子宮內(nèi)膜病變的關(guān)系,分析絕經(jīng)后子宮出血的相關(guān)因素。方法:收集2015年01月-2016年12月因絕經(jīng)后子宮出血在青海大學(xué)附屬醫(yī)院就診的患者125例,排除陰道、宮頸病變、卵巢輸卵管腫瘤所致的出血,以及1年內(nèi)應(yīng)用激素類藥物的患者,記錄患者一般情況,查患者血中性激素水平,經(jīng)陰超測定子宮內(nèi)膜厚度,宮腔鏡檢查子宮內(nèi)情況,所有患者行診刮術(shù)或?qū)m腔鏡下活檢術(shù),取出組織送病理學(xué)檢查。結(jié)果:絕經(jīng)后子宮出血病例125例中,出血原因以良性病變?yōu)橹?占77.6%(97/125),其次為惡性病變28例,占22.4%。絕經(jīng)后子宮出血大多發(fā)生在60歲以前,占61.6%(77/125),此時良性病變53.6%(67/125),惡性病變8.0%(10/125),隨著年齡增長,惡性腫瘤發(fā)病率有逐漸增高趨勢;絕經(jīng)后子宮出血多發(fā)生于絕經(jīng)1-5年,占48.0%(60/125),此時的病變以良性器質(zhì)性病變?yōu)橹?隨著絕經(jīng)時間的延長,惡性腫瘤所占的比例有逐漸升高的趨勢,絕經(jīng)10年以上惡性腫瘤的發(fā)生率高達15.2%(19/125);增生性內(nèi)膜子宮內(nèi)膜厚度多≤8mm,子宮內(nèi)膜癌內(nèi)膜厚度多8mm,兩者存在統(tǒng)計學(xué)差異(P0.05)。良惡性病變的宮腔深度、出血持續(xù)時間有差異(P0.05)。子宮內(nèi)膜癌27例中雌激素升高的12例占44.4%,高血壓10例占32.3%,糖尿病8例占30.0%,超重或肥胖14例占51.9%。結(jié)論:(1)125例絕經(jīng)后子宮出血原因中以良性病變?yōu)橹?惡性病變次之;(2)隨著絕經(jīng)年齡的增長、絕經(jīng)年限的延長、子宮內(nèi)膜厚度的增加,子宮內(nèi)膜癌的發(fā)生率逐漸升高;(4)宮腔體積明顯增大、出血持續(xù)時間明顯延長時,要高度懷疑子宮內(nèi)膜癌;(6)高血壓、糖尿病、肥胖在子宮內(nèi)膜的發(fā)生發(fā)展中具有一定作用,積極治療可能預(yù)防內(nèi)膜癌的發(fā)生。
[Abstract]:Objective: to investigate the causes of postmenopausal uterine bleeding in 125 cases in Qinghai, and the relationship between the age, menopause years, endometrial thickness, uterine cavity depth, bleeding duration and endometrial lesions. To analyze the related factors of postmenopausal uterine bleeding. Methods: 125 cases of postmenopausal uterine bleeding were collected from January 2015 to December 2016 in the affiliated Hospital of Qinghai University. The bleeding caused by vaginal, cervical and ovarian fallopian tube tumors was excluded. And the patients who used hormone drugs within 1 year, recorded the general condition of the patients, checked the level of serum sex hormone, measured the thickness of endometrium by vaginal ultrasound, examined the condition of uterus by hysteroscopy, and all the patients underwent curettage or biopsy under hysteroscopy, and all the patients were treated with curettage or hysteroscopic biopsies. Take out the tissue and send it for pathological examination. Results: among 125 cases of postmenopausal uterine bleeding, benign lesions accounted for 77.6% (97 / 125), followed by malignant lesions (22.4%). The majority of postmenopausal uterine bleeding occurs before the age of 60, accounting for 61.6% (77 / 125). At this time, the benign lesion is 53.6% (67 / 125), and the malignant lesion is 8.0% (10 / 125). With the age, the rate of uterine bleeding is 61.6% (77 / 125). The incidence of malignant tumor increased gradually. Most of the postmenopausal uterine bleeding occurred 1-5 years after menopause, accounting for 48.0% (60 / 125). At this time, benign organic lesions were the main pathological changes, and with the prolongation of menopause time, the proportion of malignant tumors increased gradually. The incidence of malignant tumors over 10 years after menopause was 15.2% (19 / 125). The endometrial thickness of proliferative endometrium was less than 8 mm, and the endometrial thickness of endometrial carcinoma was 8 mm. There was statistical difference between the two groups (P0.05). There were significant differences in uterine cavity depth and bleeding duration between benign and malignant lesions (P0.05). Among 27 cases of endometrial carcinoma, 12 cases (44.4%) had elevated estrogen, 10 cases (32.3%) had hypertension, 8 cases (30.0%) had diabetes, and 14 cases (51.9%) were overweight or obesity. Conclusion: (1) among 125 cases of postmenopausal uterine bleeding, benign lesions are the main causes, followed by malignant lesions. (2) with the increase of menopause age, the prolongation of menopause years and the increase of endometrial thickness, the incidence of endometrial carcinoma increased gradually. (4) the endometrial carcinoma should be highly suspected when the volume of uterine cavity is obviously enlarged and the duration of bleeding is prolonged. (6) Hypertension, diabetes and obesity play a certain role in the occurrence and development of endometrium. Active treatment may prevent the occurrence of endometrial carcinoma.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711

【相似文獻】

相關(guān)期刊論文 前10條

1 王俊文;絕經(jīng)后子宮出血診刮子宮內(nèi)膜病理診斷及其臨床意義[J];山西醫(yī)藥雜志;2001年02期

2 朱萍芳;田華;;150例絕經(jīng)后子宮出血臨床與病理分析[J];工企醫(yī)刊;2001年02期

3 林瓊珊,朱新興;絕經(jīng)后子宮出血78例分析[J];中國熱帶醫(yī)學(xué);2002年02期

4 孟俊梅;絕經(jīng)后子宮出血165例病因分析[J];中國煤炭工業(yè)醫(yī)學(xué)雜志;2003年03期

5 陳瑞蓮,柳嵐,陳萍,宋淑欽;259例絕經(jīng)后子宮出血臨床病理分析[J];莆田學(xué)院學(xué)報;2004年03期

6 徐鳳琳;李淑霞;張春慶;;106例絕經(jīng)后子宮出血患者的子宮內(nèi)膜病理學(xué)觀察[J];醫(yī)學(xué)研究通訊;2004年01期

7 王小平;絕經(jīng)后子宮出血249例診刮病理分析[J];臨床與實驗病理學(xué)雜志;2005年03期

8 孫會欣;武傳英;;絕經(jīng)后子宮出血68例原因分析[J];中國現(xiàn)代醫(yī)藥雜志;2006年02期

9 于振國;;絕經(jīng)后子宮出血188例臨床分析[J];中國基層醫(yī)藥;2006年10期

10 黃曉靈;;絕經(jīng)后子宮出血20例分析[J];社區(qū)醫(yī)學(xué)雜志;2007年12期

相關(guān)會議論文 前4條

1 羅兵;李誠信;;手術(shù)治療絕經(jīng)后子宮出血52例臨床分析[A];紀念卓越的人民醫(yī)學(xué)家林巧稚大夫誕辰100周年——全國婦產(chǎn)科高級學(xué)術(shù)論壇論文集[C];2001年

2 王曉君;熊輝;羅明燕;黎惠蘭;;絕經(jīng)后子宮出血60例臨床分析[A];全國中西醫(yī)結(jié)合生殖健康學(xué)術(shù)研討會論文及摘要集[C];2004年

3 屈麗華;徐亞平;徐珠鳳;;宮腔鏡在絕經(jīng)后子宮出血診治中的臨床應(yīng)用[A];浙江省微創(chuàng)外科學(xué)術(shù)交流會暨浙江省醫(yī)學(xué)會微創(chuàng)外科學(xué)分會成立大會論文匯編[C];2008年

4 艾星子·艾里;丁巖;王玉英;;絕經(jīng)后子宮出血的宮腔鏡檢查[A];紀念卓越的人民醫(yī)學(xué)家林巧稚大夫誕辰100周年——全國婦產(chǎn)科高級學(xué)術(shù)論壇論文集[C];2001年

相關(guān)重要報紙文章 前1條

1 副主任醫(yī)師 魏開敏;絕經(jīng)后出血要重視無需畏懼[N];保健時報;2005年

相關(guān)碩士學(xué)位論文 前4條

1 尹正芳;125例絕經(jīng)后子宮出血臨床資料分析[D];青海大學(xué);2017年

2 張鳳芝;宮腔鏡檢查在絕經(jīng)后子宮出血中的應(yīng)用價值研究[D];鄭州大學(xué);2011年

3 石健;絕經(jīng)后子宮出血600例分析[D];大連醫(yī)科大學(xué);2010年

4 徐永前;陰道超聲和宮腔鏡檢查診斷絕經(jīng)后子宮出血的臨床應(yīng)用研究[D];山東大學(xué);2007年

，

本文編號：2450897