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目的:探讨绝经后妇女B超检查显示子宫内膜增厚而无症状者的子宫内膜病理变化。方法:对绝经后B超显示子宫内膜增厚无症状患者(无症状组)及同期绝经后B超显示子宫内膜增厚伴有阴道出血者(出血组)进行诊断性刮宫与病理检查结果比较。结果:无症状组子宫内膜增厚的86例患者中,非器质性病变44例(51.16%),良性病变42例(48.84%),无恶性及癌前病变;出血组子宫内膜增厚的79例中,非器质性病变48例(60.76%),良性病变17例(21.52%),恶性14例(17.72%)。无症状组随着年龄增大、绝经年限延长、内膜厚度增加,其良性病变呈上升趋势(P<0.05);出血组随着年龄增大、绝经年限延长、内膜厚度增加,其恶性病变呈上升趋势(P<0.05);其中无症状绝经后妇女B超示子宫内膜增厚者中内膜病变与内膜厚度和体质量指数(BMI)相关。结论:绝经后子宫内膜增厚不伴阴道出血时,多为良性病变,对于肥胖、内膜厚及绝经年龄较长患者更应重视。绝经后子宫内膜增厚伴有阴道出血时,恶性病变比例显著升高。
OBJECTIVE: To investigate the pathological changes of endometrium in postmenopausal women with B-ultrasound revealed asymptomatic thickened endometrium. Methods: The results of diagnostic curettage and pathological examination of asymptomatic patients with endometrial hyperplasia (asymptomatic group) in postmenopausal B-ultrasound and B-ultrasound of endometrial hyperplasia with vaginal bleeding (bleeding group) in the same period Compare Results: Of the 86 patients with asymptomatic endometrial thickening, 44 (51.16%) had non-organic lesions and 42 (48.84%) had benign lesions without malignancy and precancerous lesions. The endometrial hyperplasia Of the 79 cases with thick lesions, 48 (60.76%) had non-organic lesions, 17 (21.52%) had benign lesions and 14 (17.72%) had malignant lesions. Asymptomatic group with age, prolonged menopause, endometrial thickness increased, the benign lesions showed an upward trend (P <0.05); hemorrhage group with age, prolonged menopause, increased intimal thickness, the malignant lesions (P <0.05). In endometrial lesions in asymptomatic postmenopausal women with B-ultrasound in endometrial thickening were related to intima thickness and body mass index (BMI). Conclusion: Postmenopausal endometrial thickening is not associated with vaginal bleeding, mostly benign lesions, for obesity, intima thickness and menopausal age patients should pay more attention. After menopause, endometrial thickening associated with vaginal bleeding, the proportion of malignant lesions increased significantly.