80例圍絕經(jīng)期陰道出血患者的病因分布及惡性病變發(fā)生的相關(guān)因素分析

祁燕 徐桂冉 郁金芬

【摘要】目的：統(tǒng)計(jì)圍絕經(jīng)期陰道出血的病因，并對(duì)惡性病變的危險(xiǎn)因素進(jìn)行分析。方法：采用問(wèn)卷調(diào)查結(jié)合病歷記錄的方式對(duì)80例圍絕經(jīng)期陰道出血婦女的臨床資料進(jìn)行分析，了解圍絕經(jīng)期婦女出血原因和可能的11個(gè)危險(xiǎn)因素。結(jié)果：圍絕經(jīng)期陰道出血病因?yàn)榱夹圆∽?5例（18.8%），惡性病變10例（12.5%），功能失調(diào)性子宮出血55例（68.8%）。單因素和多因素Logistic回歸分析顯示，就診年齡、子宮內(nèi)膜厚度和陰道出血持續(xù)時(shí)間對(duì)惡性病變的發(fā)生有顯著影響。結(jié)論：功能失調(diào)性子宮出血是圍絕經(jīng)期陰道出血的首要原因，就診年齡高、陰道出血時(shí)間持續(xù)長(zhǎng)、子宮內(nèi)膜增厚是圍絕經(jīng)期陰道出血惡性病變的危險(xiǎn)因素，臨床上應(yīng)當(dāng)予以重視。

【關(guān)鍵詞】圍絕經(jīng)期陰道出血；病因；危險(xiǎn)因素

Clinical analysis of the reason of vaginal bleeding during perimenopausal periodQI Yan， XU Guiran， YU Jinfen. Department of Obstetrics and Gynecology， Zhangjiagang City Traditional Chinese Medical Hospital， Suzhou 215600， Jiangsu， China

【Abstract】Objectives： To investigate the reason of vaginal bleeding during perimenopausal period and the risk factors influencing the occurrence of malignancy. Methods： Questionnaire and medical records were adopted to investigate the clinical data of 80 patients with vaginal bleeding during perimenopausal period to study the reason of vaginal bleeding during perimenopausal period and analyze possible risk factors. Results： In all patients， 15 cases （18.8%） were with benign lesions， 10 cases （12.5%） were with malignant lesions and 55 cases （68.8%） were with dysfunctional uterine bleeding. Univariate and multivariate logistic regression analysis indicated that mean age， endometrial thickness and duration of vaginal bleeding significantly influenced the malignancy rate. Conclusion： Dysfunctional uterine bleeding is the primary reason of vaginal bleeding during perimenopausal period. High age， long lasted vaginal bleeding and endometrial thickening are risk factors for perimenopausal bleeding malignant lesions， which should be paid attention in clinical practice.

【Key words】Vaginal bleeding during perimenopausal period； Reason； Risk factor

【中圖分類(lèi)號(hào)】R711【文獻(xiàn)標(biāo)志碼】A

圍絕經(jīng)期是指婦女從生育功能旺盛走向衰退的過(guò)渡時(shí)期[1]。流行病學(xué)調(diào)查顯示，圍絕經(jīng)期陰道出血的發(fā)病原因較多，基本可分為良性病變、惡性病變和功能失調(diào)性子宮出血[2]。不同的病因?qū)颊叩慕】涤绊懸灿休^大區(qū)別，對(duì)于惡性病變?nèi)裟芗霸缭\斷有助于幫助患者及早治療和干預(yù)。現(xiàn)對(duì)我院入院治療的圍絕經(jīng)期陰道出血患者發(fā)病原因及惡性病變危險(xiǎn)因素進(jìn)行分析，以期了解惡性病變發(fā)生的原因。

1資料與方法

1.1一般資料

選取2014年1月至12月在我院門(mén)診就診的圍絕經(jīng)期陰道出血患者80例。要求所有患者均為首次因陰道出血而就診，無(wú)婦科手術(shù)史，無(wú)長(zhǎng)期服用避孕類(lèi)藥物史，一般狀況可，就診前一年內(nèi)無(wú)住院治療史。……