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目的:探讨无症状绝经期宫腔积液的常见原因及适宜的临床处理方法。方法:回顾性分析68例无症状的绝经期宫腔积液患者的临床资料,总结宫腔镜检查结果及病理诊断。结果:经病理诊断68例患者中,36例提示子宫内膜病理性改变,常见的病因依次为萎缩性内膜炎、内膜增殖症、内膜息肉、内膜不典型增生和子宫内膜癌。阴道超声影像与子宫内膜病理改变密切相关,单纯性积液和伴内膜异常回声组间比较有统计学差异(P<0.05),宫腔积液量的多少与子宫内膜的病变程度密切相关(P<0.05)。结论:5 mm以内的单纯宫腔积液可密切随访,积液量超过5 mm或伴有子宫内膜的异常影像需尽早行宫腔镜检查,以明确子宫内膜的性质。
Objective: To investigate the common causes of asymptomatic uterine effusion and the appropriate clinical treatment. Methods: The clinical data of 68 asymptomatic menopausal women with uterine effusion were retrospectively analyzed. The results of hysteroscopy and pathological diagnosis were summarized. Results: Of the 68 patients diagnosed by pathology, 36 cases showed pathological changes of endometrium, the most common causes were atrophic endometritis, endometrial hyperplasia, endometrial polyps, endometrial dysplasia and endometrial carcinoma . Vaginal ultrasound images and pathological changes of endometrium are closely related, simple effusion and endometrial abnormal echo group were statistically significant difference (P <0.05), the amount of fluid in the uterine cavity and the degree of endometrial lesions close Related (P <0.05). Conclusion: Uterine fluid within 5 mm can be closely followed up. Hysteroscopy should be performed as soon as possible if the effusion volume exceeds 5 mm or the abnormal image with endometrium is involved to clarify the nature of the endometrium.