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目的:应用子宫内膜细胞学方法探讨宫内节育器(IUD)对子宫内膜的影响。方法:应用子宫内膜细胞采集器在募集对象取出IUD时采集子宫内膜组织制片,样本集中寄往北京大学附属医院妇产科宫腔细胞学检测中心阅片。结果:有症状组和无症状组子宫内膜细胞病理未见异常率及不典型增生发生率差异有统计学意义(P<0.01),良性增生性改变发生率差异有统计学意义(P<0.05)。阴道流血症状发生细胞学诊断未见异常人群组与良性增生人群组差异有统计学意义(P<0.05),与不典型增生人群组差异有统计学意义(P<0.01);肥胖情况细胞学诊断非典型增生人群组和良性增生人群组均高于未见异常人群组,但差异无统计学意义(P>0.05),高血压、初潮早等其他高危因素情况细胞学诊断不典型增生人群组和良性增生人群组均高于未见异常人群组,但差异无统计学意义(P>0.05)。宫内节育器类型组两两对比,良性增生和不典型增生的发生率均无统计学意义(P>0.05)。结论:放置IUD后子宫异常出血常伴有子宫内膜良性增生及非典型增生,子宫内膜细胞学异常与宫内节育器类型无明显关系。取器时行子宫内膜细胞学检测,可以对子宫内膜状况有初步了解,以便正确拟定诊治方案。
Objective: To investigate the effect of intrauterine device (IUD) on endometrium by endometrial cytology. Methods: The endometrial cell harvester was used to collect the endometrial tissue samples when IUD was taken. The samples were collected and sent to the Obstetrics and Gynecology Center of Peking Union Medical College Hospital for examination. Results: There was no significant difference in pathological features of endometrial cells between the symptomatic and asymptomatic groups (P <0.01), and the incidence of benign proliferative changes was statistically significant (P <0.05 ). There was no significant difference in the diagnosis of vaginal bleeding among the group of patients with benign prostatic hyperplasia (P <0.05). There was significant difference between the group of hyperplasia and atypical hyperplasia (P <0.01) Cytological diagnosis of atypical hyperplasia and benign hyperplasia groups were higher than those without abnormalities, but the difference was not statistically significant (P> 0.05), hypertension, early menarche and other high risk cytology Atypical hyperplasia and benign hyperplasia groups were higher than those without abnormal group, but the difference was not statistically significant (P> 0.05). There were no significant differences in the pairwise comparisons of intrauterine device type, benign hyperplasia and dysplasia (P> 0.05). Conclusion: Uterine bleeding after IUD placement is often associated with benign endometrial hyperplasia and atypical hyperplasia. The abnormal endometrial cytology has no relationship with the type of IUD. When taking the line of endometrial cytology test, you can have a preliminary understanding of the endometrial conditions in order to correctly develop the diagnosis and treatment programs.