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目的探讨绝经后无症状子宫内膜增厚患者的病理类型及其临床特点。方法分析102例于2012年1月-2016年6月就诊于天津市第四医院,绝经1年以上无症状但阴道B超检查子宫内膜厚度>4 mm的患者。行宫腔镜检查、分段诊断性刮宫术,部分患者可疑部位活检,均送病理检查。比较不同子宫内膜厚度状态下的子宫内膜病理类型。结果102例绝经后无症状子宫内膜增厚患者中,子宫内膜厚度4~8 mm者,符合绝经后改变20例(43.48%)、良性病变25例(54.35%)、子宫内膜非典型增生1例(2.17%),子宫内膜癌0例(0.00%)。子宫内膜厚度>8 mm者,符合绝经后改变5例(8.93%)、良性病变46例(82.14%)、子宫内膜非典型增生3例(5.36%)、子宫内膜癌2例(3.57%)。两组子宫内膜病变构成比差异有统计学意义(P<0.05)。结论绝经后无症状子宫内膜增厚患者以子宫内膜良性病变为主。但是对于子宫内膜厚度>8 mm者,子宫内膜良性病变、潜在恶性病变及恶性病变的发生率增加,建议进一步宫腔镜检查及治疗。
Objective To investigate the pathological types and clinical features of asymptomatic endometrial thickening in postmenopausal women. Methods Totally 102 patients with asymptomatic but vaginal B-ultrasound of endometrial thickness> 4 mm who visited the Fourth Hospital of Tianjin from January 2012 to June 2016 were analyzed. Hysteroscopy, segmental diagnostic curettage, biopsy of some patients suspected parts, were sent to pathological examination. Endometrial thickness was compared with different endometrial pathological types. Results Among the 102 cases of asymptomatic endometrial thickening in postmenopausal women, the thickness of endometrium was from 4 to 8 mm, which was consistent with the change of postmenopausal women in 20 cases (43.48%), benign lesions in 25 cases (54.35%), endometrial atypia One case of hyperplasia (2.17%) and 0 case of endometrial carcinoma (0.00%). Endometrial thickness> 8 mm, in line with the postmenopausal change in 5 cases (8.93%), benign lesions in 46 cases (82.14%), endometrial atypical hyperplasia in 3 cases (5.36%), endometrial cancer in 2 cases (3.57 %). The two groups of endometrial lesions constitute a significant difference (P <0.05). Conclusion Asymptomatic endometrial thickening in postmenopausal women with benign endometrial lesions. However, for endometrial thickness> 8 mm, the incidence of benign endometrial lesions, potentially malignant lesions and malignant lesions is increased, and further hysteroscopy and treatment are recommended.