【摘要】 目的探讨对绝经后妇女子宫内膜增厚的诊断方法。方法对同期绝经后386例不伴阴道出血(无出血组)和687例伴有阴道出血(出血组)的子宫内膜增厚患者进行诊断性刮宫和病理分析。结果无出血组病理检查符合绝经后正常表现(绝经期内膜、无组织而细胞学涂片阴性)占75．9%(293例),显著高于出血组的65．8%(452例,P＜0．001)。无出血组恶性病变为0．3%(1例),显著低于出血组的8．6%(59例,P＜0．001)；出血组的良性病变(内膜不规则增生、单纯增生及内膜息肉)占23．8%,与无出血组(25．6%)的差异无显著性(P＞0．05)。结论绝经后不伴阴道出血的子宫内膜增厚患者,可暂不予诊断性刮宫,但必须严密随访。更多还原

【Abstract】 Objective To appraise the diagnostic method for abnormal endometrial thickening of postmeno- pausal women. Methods 386 nonbleeding postmenopausal women (nonbleeding group) and 687 postmenopausal bleeding women (bleeding group) with abnormal endometrial thickening were curettaged for pathologic analysis. Results 293 of 386 women of nonbleeding group were identified to have normal histological findings significantly higher than those of the bleeding group(75.9% versus 65.8%, P＜0. 001). Cancer was present in only one woman of the nonbleeding group(0.3%) significantly less than the bleeding group in which 55 women were found to have endometrial cancer and 4 with atypical hyperplasia(8.6%, P＜0. 001). There was no statistical difference in occur- rence of benign hyperplasia or polyps among the two groups(23.8% and 25.6 respectively P＞0.05). Conclusion Curettage of the endometrium may temporarily be avoided in nonbleeding postmenopausal women with abnormal endometrial thickening, but should be followed and watched closely.更多还原