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Wysłany: Śro 11:49, 23 Mar 2011
Temat postu: ghd outlet 171 cases of postmenopausal bleeding Cl
Postmenopausal bleeding clinical analysis of 171 cases
Nature difficult to set,
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, so the older women appeared postmenopausal bleeding, still regarded as danger signals. Abnormal uterine bleeding is a common gynecological symptoms, one of the high incidence of postmenopausal bleeding complex causes, the psychological burden of patients is relatively heavy. Therefore, as soon as possible causes of bleeding clearly is conducive to take the appropriate therapeutic measures, and ease the mental stress of patients. In this paper, the past 2 years in our hospital 171 cases of gynecological treatment of postmenopausal vaginal bleeding of clinical data. Clinical data 1 1.1 General Information: July 2005 ~ 2OO7 in July gynecology in our hospital 171 cases of postmenopausal bleeding were treated, aged 41 to 72 years, mean 55.21 years, natural menopause 1 to 25 years, parallel diagnostic curettage and (or) hysterectomy and pathological examination. 1.2 Results 1.2.1 postmenopausal bleeding in patients with pathological analysis of the endometrium: endometrial biopsy in all patients and (or) hysterectomy specimens were confirmed by pathological examination. Pathological diagnosis of 69 cases of atrophic endometrium (46.7%), proliferative endometrium in 63 cases (42.57%),
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, secretory endometrium in 16 cases (10.81%); 15 endometrial cancer cases accounted for 8.77%; 8 cases of endometritis 4.68%, including 3 cases of intrauterine device caused. 1.2.2 The causes of bleeding and the relationship between menopause: Table 1. Table 1 menopause and causes of bleeding (cases) 1.2.3 endometrial cancer and menopause and menopausal age relationships: with time, patients with postmenopausal bleeding ratio of endometrial cancer increased. 2 to discuss a variety of postmenopausal bleeding is a symptom of causes, once considered a sign of malignancy and much attention. Our data showed 148 cases of dysfunctional uterine bleeding accounts for 86.55%, suggesting that in patients with postmenopausal bleeding, mainly non-organic diseases, which is estrogen in postmenopausal women at a low level, and FSH for the high level,
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, high FSH stimulation of ovarian atrophy,
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, the ovarian cortex and other stromal cell proliferation, estrogen acts directly on the endometrium. Although postmenopausal ovarian cortical atrophy, resulting in decreased estrogen, but ovarian stromal and adrenal cortex can produce androgens,
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, male hormones can be transformed into estrone, the phenomenon of endometrial hyperplasia can be presented. In addition, the early years of menopause, some women, ovarian function has not been fully failure, in a small amount of savings under the action of estrogen, endometrial hyperplasia, when estrogen fluctuations that can cause bleeding. Atrophic endometrium of postmenopausal uterine bleeding may also occur, this set of data shows that non-organic disease in the occurrence of atrophic endometrium is the main reason for postmenopausal bleeding. This may result from atherosclerosis uterine endometrial bleeding, endometrial stromal diffuse bleeding, uterine prolapse or uterine retroversion impede blood circulation, sinus congestion, rupture causing hemorrhage, cystic degeneration of the endometrial glands rupture caused by bleeding. In this group accounted for 15 cases of endometrial cancer, 8.97%, although a small number of cases, but also in line with long-menopausal, menopausal age, the characteristics of a high proportion of late onset. Therefore, for older women appear to cause vaginal bleeding full attention, at any time curettage biopsy, if necessary, with hysteroscopy, colposcopy and other means, biopsy of suspicious lesions, a clear diagnosis, timely treatment, if necessary, to do ultrasonography, endocrine determination and laparoscopic exploration in order to avoid omission of ovarian cancer, fallopian tube cancer cases caused by vaginal bleeding. Causes of vaginal bleeding after menopause complex and diverse, if timely and thorough examination, a clear causes of bleeding, time to give the best treatment, can reduce mortality and improve quality of life of elderly women. Hysteroscopy is considered the current highest rate of diagnosis of intrauterine lesions positive for one of the means, and its easy operation, safety, observe the clear, comprehensive, and biopsy with high accuracy, can be found in curettage of the missing small lesions, such as the uterus membrane polyps, submucosal fibroids and smaller foci of small. Therefore, hysteroscopy is postmenopausal bleeding patients, early to determine whether intrauterine effective means of organic disease. 3
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