绝经期子宫内膜息肉临床特点分析

摘要

目的 探讨绝经期子宫内膜息肉(endometrial polyp, EP)的临床特点,进一步指导临床诊治. 方法 回顾分析2005年6月~2014年10月我院妇科微创中心经病理确诊的403例EP的临床资料. 结果 EP占同期绝经期宫腔内病变51.7%(403/779),有绝经后出血等临床症状占43.4%(175/403).超声检查77.9%(314/403)的病人提示内膜回声不均,内膜厚度(0.8±0.4)cm;48.4%(195/403)的病人探及宫腔内占位性病变.宫腔镜诊断EP与病理的符合率达88.6%(357/403).病理结果显示良性息肉占93.3%(376/403),恶性息肉占6.7%(27/403).同时对息肉外宫腔其余部位内膜活检300例,EP同时合并内膜单纯增生及复杂增生占20.3%(61/300),非典型增生占2.7%(8/300),子宫内膜癌占1.0%(3/300). 结论 EP是绝经期女性最常见的宫腔内病变,宫腔镜是EP有效的诊治方法,需要同时行子宫内膜活检以防遗漏病变.%Objective To investigate clinical features of endometrial polyps(EP) in postmenopausal patients and to provide clues for clinical diagnosis and treatment.Methods Based on the pathologic diagnosis, there were 403 postmenopausal EP between June 2005 and October 2014 in our hospital.The clinical data were retrospectively analyzed.Results The percentage of EP accounted for 51.7%(403/779) of endometrial lesions in menopausal patients during the same period.The percentage of clinical symptoms, such as menopausal bleeding, was 43.4%(175/403).Under ultrasound examinations, there were 77.9% (314/403) of cases with inhomogeneous echo and the average thick of endometrium was (0.8±0.4) cm.About 48.4%(195/403) of cases had occupying lesions in the uterine cavity.The coincidence rate between hysteroscopy diagnosis of EP and pathology was 88.6%(357/403).Based on pathology, the percentage of benign and malignant polyps was 93.3%(376/403) and 6.7% (27/403), respectively.Accompanied with EP, the percentages of endometrial simple hyperplasia and complex hyperplasia, atypical hyperplasia, and endometrial carcinoma were 20.3%(61/300), 2.7%(8/300), and 1.0%(3/300), respectively.Conclusions In postmenopausal women, EP is the most common intrauterine lesions.Hysteroscopy is the effective method for EP diagnosis and treatment.It is noted that simultaneous endometrial biopsy is required to avoid misdiagnosis.