绝经后阴道出血236例病因分析

目的：探讨绝经后阴道出血（Postmenopausal bleed-ing,PMB)的病因。方法：分析236例绝经后阴道出血并行活检、诊断性刮宫及（或）子宫切除患的临床和病理资料。结果：恶性肿瘤引起的出血占18.6%，良性疾病占47.5%，非器质性疾病占33.9%。子宫内膜病理检查显示增生性56例，分泌性8例，萎缩性16例，炎性16傲卢肉性4例，恶性12例，恶性肿瘤以宫颈癌和子宫内膜癌为主，患出血时年龄大，绝经年阴长（5a以上），恶性肿瘤发生率高。结论：对PMB应引起足够重视，常规行妇科检查和必要的辅助检查以明确病因。做到早期发现，早期诊断，早期治疗，以期得到较好的预后。

Analysis of the pathogenesis of postmenopausal bleeding in 236 cases

AIM: To investigate the pathogenesis of postmenopausal bleeding (PMB). METHODS: The cause and pathologic features in 236 cases of biopsy,curettage and/or hysterectomy due to postmenopausal bleeding were analyzed. RESULTS: The main causes of PMB were malignant tumors (18.6%), benign diseases (47.5%) and nonorganic diseases (33.9%). Histopathological examination revealed proliferous endometrium in 56 cases, secretory endometrium in 8 cases, atrophic endometrium in 16 cases, inflammatory endometrium in 16 cases, polypus endometrium in 4 cases and malignant endometrium in 12 cases. Cervical and endometrial cancers were common among the malignant cases. The incidence of malignant tumor is higher in senile women with longer duration of menopause (>5 years). CONCLUSION: More attention should be paid to PMB patients. Routine gynecologic and necessary ancillary examinations can identify the cause of PMB and early diagnosis and treatment will help patients to get better prognosis.