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韩国女性绝经后出血的常见原因:来自单一医疗中心的10年结果

Common Causes of Postmenopausal Bleeding in Korean Women: 10-Year Outcomes from a Single Medical Center.

作者信息

Kim Min Kyoung, Jung Yeon Soo, Chon Seung Joo, Yun Bo Hyon, Cho Sihyun, Choi Young Sik, Lee Byung Seok, Seo Seok Kyo

机构信息

Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2017 May;32(5):830-834. doi: 10.3346/jkms.2017.32.5.830.

DOI:10.3346/jkms.2017.32.5.830
PMID:28378558
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5383617/
Abstract

The common causes of postmenopausal bleeding (PMB), according to the data from the western world, are atrophy, hormone replacement therapy (HRT), endometrial cancer, etc. We conducted a retrospective study to assess whether the causes of PMB in Korean postmenopausal women are similar to those already known. This retrospective study used 10-year medical records (March 2005 to December 2014) of 792 PMB women in the Yonsei University Health System. The data were divided into 2 categories by 5-year intervals to compare the differences between the 2 periods. The most common cause of PMB in Korean women was atrophy (51.1%). Polyps and HRT were the second, followed by anticoagulant medications, cervical cancer, and endometrial cancer. The proportion of patients with cervical cancer significantly decreased during the second half of the decade (8.7% vs. 5.2%; P = 0.048). Although no significant change was noted for HRT, its rank was higher during the latter 5-year period. Only the most common cause of PMB was the same as the conventional data. Interestingly, the proportion of patients with cervical cancer decreased during the latter half of the decade, reflecting the changes in the nation's cancer prevalence rate, while the use of HRT increased.

摘要

根据西方世界的数据,绝经后出血(PMB)的常见原因包括萎缩、激素替代疗法(HRT)、子宫内膜癌等。我们进行了一项回顾性研究,以评估韩国绝经后女性PMB的原因是否与已知原因相似。这项回顾性研究使用了延世大学医疗系统中792名PMB女性的10年医疗记录(2005年3月至2014年12月)。数据按5年间隔分为两类,以比较两个时期之间的差异。韩国女性PMB最常见的原因是萎缩(51.1%)。息肉和HRT位居第二,其次是抗凝药物、宫颈癌和子宫内膜癌。十年后半期宫颈癌患者的比例显著下降(8.7%对5.2%;P = 0.048)。虽然HRT没有显著变化,但其排名在后一个5年期间更高。只有PMB最常见的原因与传统数据相同。有趣的是,十年后半期宫颈癌患者的比例下降,反映了该国癌症患病率的变化,而HRT的使用增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312b/5383617/53226418af48/jkms-32-830-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312b/5383617/8200472eb788/jkms-32-830-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312b/5383617/16accd8e354b/jkms-32-830-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312b/5383617/53226418af48/jkms-32-830-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312b/5383617/8200472eb788/jkms-32-830-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312b/5383617/16accd8e354b/jkms-32-830-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312b/5383617/53226418af48/jkms-32-830-g003.jpg

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本文引用的文献

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Structured Hysteroscopic Evaluation of Endometrium in Women With Postmenopausal Bleeding.绝经后出血女性子宫内膜的结构化宫腔镜评估
J Minim Invasive Gynecol. 2015 Nov-Dec;22(7):1215-24. doi: 10.1016/j.jmig.2015.06.018. Epub 2015 Jun 30.
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Changing trends in the incidence (1999-2011) and mortality (1983-2013) of cervical cancer in the Republic of Korea.韩国宫颈癌发病率(1999 - 2011年)及死亡率(1983 - 2013年)的变化趋势
Epidemiol Health. 2015 May 29;37:e2015024. doi: 10.4178/epih/e2015024. eCollection 2015.
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Reproducibility of Endometrial Pathologic Findings Obtained on Hysteroscopy, Transvaginal Sonography, and Gel Infusion Sonography in Women With Postmenopausal Bleeding.
绝经后出血女性宫腔镜检查、经阴道超声检查及凝胶注入超声检查获得的子宫内膜病理结果的可重复性
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4
Transvaginal ultrasound measurement of the endometrium remains the first line test for investigating postmenopausal bleeding but integration of patient characteristics into testing may further improve diagnostic algorithms.经阴道超声测量子宫内膜仍然是调查绝经后出血的一线检查方法,但将患者特征纳入检查可能会进一步改进诊断算法。
BJOG. 2016 Feb;123(3):447. doi: 10.1111/1471-0528.13438. Epub 2015 May 29.
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Discontinuation rates of menopausal hormone therapy among postmenopausal women in the post-WHI study era.在妇女健康倡议(WHI)研究时代之后,绝经后妇女中绝经激素治疗的停药率。
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Reappraisal of endometrial thickness for the detection of endometrial cancer in postmenopausal bleeding: a retrospective cohort study.绝经后出血患者子宫内膜厚度检测用于子宫内膜癌诊断的再评估:一项回顾性队列研究。
BJOG. 2016 Feb;123(3):439-46. doi: 10.1111/1471-0528.13342. Epub 2015 Mar 20.
7
Does probability guided hysteroscopy reduce costs in women investigated for postmenopausal bleeding?概率引导的宫腔镜检查能否降低绝经后出血女性的检查成本?
ScientificWorldJournal. 2015;2015:605312. doi: 10.1155/2015/605312. Epub 2015 Feb 16.
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Hysteroscopy as a valid tool for endometrial pathology in patients with postmenopausal bleeding or asymptomatic patients with a thickened endometrium: hysteroscopic and histological results.宫腔镜检查作为绝经后出血患者或子宫内膜增厚无症状患者子宫内膜病变的有效工具:宫腔镜检查及组织学结果
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