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本文对85例绝经后阴道出血临床资料进行分析,通过常规妇科检查、宫颈刮片细胞学检查,阴道镜检查、分段诊刮、宫腔镜检查、B 超检查及血 E_2测定,发现子宫内膜癌11例,卵巢恶性肿瘤2例,宫颈鳞状细胞癌1例,输卵管癌1例,直肠腺癌1例,卵巢良性肿瘤5例,生殖道炎症28例,子宫内膜息肉7例,宫颈息肉5例,子宫内膜增生反应和增生过长16例,宫颈上皮不典型增生4例,原因不明4例.其中恶性病变16例,占18.8%;良性病交和原因不明69例,占81.2%.指出恶性病变与年龄、出血时间及血清 E_2之间无明显关系.认为对绝经后阴道出血患者应积极检查,首先排除恶性病变,高E_2水平者应注意卵巢功能性肿瘤的可能.另外还应注意是否合并生殖器外(直肠及泌尿道)病变的存在,以提高确诊率.
In this paper, 85 cases of postmenopausal vaginal bleeding clinical data analysis, through routine gynecological examination, cervical smear cytology, colposcopy, sub-curettage, hysteroscopy, B-ultrasound and blood E_2 found intrauterine 11 cases of membranous cancer, 2 cases of ovarian cancer, 1 case of cervical squamous cell carcinoma, 1 case of fallopian tube cancer, 1 case of rectal adenocarcinoma, 5 cases of benign ovarian tumor, 28 cases of reproductive tract inflammation, 7 cases of endometrial polyps, Polyps in 5 cases, 16 cases of endometrial hyperplasia and hyperplasia, 4 cases of cervical epithelial dysplasia, 4 cases of unknown cause, of which 16 cases of malignant lesions, accounting for 18.8%; 69 cases of benign disease and unexplained cause, accounting for 81.2 % .There is no significant relationship between malignant lesions and age, bleeding time and serum E_2.It is considered that postmenopausal vaginal bleeding patients should be actively checked, first rule out malignant lesions, high E_2 level should pay attention to the possibility of ovarian tumors. Should pay attention to whether the combined genital outside (rectum and urinary tract) the presence of lesions to improve the diagnosis rate.