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越南围绝经期和绝经后出血妇女腔内子宫病变临床特征评估:一项双中心观察性描述性分析

Evaluating Clinical Features in Intracavitary Uterine Pathologies among Vietnamese Women Presenting with Peri-and Postmenopausal Bleeding: A Bicentric Observational Descriptive Analysis.

作者信息

Nguyen Phuc Nhon, Nguyen Van Tuan

机构信息

Department of High-Risk Pregnancy and Tu Du Clinical Research Unit (TD-CRU), Tu Du Hospital, Ho Chi Minh City, Vietnam.

Department of Obstetrics and Gynecology, Hue Medical College, Thua Thien Hue, Vietnam.

出版信息

J Midlife Health. 2022 Jul-Sep;13(3):225-232. doi: 10.4103/jmh.jmh_81_22. Epub 2023 Jan 14.

Abstract

BACKGROUND

Intracavitary uterine pathologies (IUPs) may be resulting in vaginal bleeding in perimenopausal and postmenopausal women. Especially, malignant disease needed to be investigated due to its adverse impact on the quality of mid-life women as well as the burden of health-care costs in low- and middle-income countries such as Vietnam.

OBJECTIVE

Thereby, through this study, we aimed to assess the major clinical features of IUPs in women with perimenopausal and postmenopausal bleeding women.

MATERIALS AND METHODS

This was a cross-sectional observational study at Hue University Hospital and Hue Central Hospital from June 2016 to June 2019. The study enrolled 150 women above 40 years old involving with intrauterine bleeding.

RESULTS

The mean age of the study population was 51.51 ± 7.65. The most common symptom in perimenopausal women was menorrhagia, up to 62.2% of cases. In addition to intrauterine bleeding, there were 54.7% of cases had at least one other functional symptom, they were pale skin (35.9%), and lower abdominal pain (31.3). Endometrial hyperplasia (EH) was the most common pathology in both groups with perimenopausal and postmenopausal bleeding (PMB), respectively, 66.7% and 51.7%. In PMB group, endometrial cancer (EC) occupied approximately 38.3% following EH. Our study revealed age, menstrual characteristics, and diabetes in relation to malignant disease. Other factors seemed to be less associated with EC.

CONCLUSIONS

Menorrhagia was the most common type of abnormal uterine bleeding in perimenopausal women. Besides vaginal bleeding, others symptoms such as pale skin, pelvic pain, and fatigue were also common. Length day and blood loss before hospitalization in perimenopausal women were greater significantly than that in postmenopausal women. Age, menstrual characteristics, and diabetes increased the risk of EC in women with PMB.

摘要

背景

腔内子宫病变(IUPs)可能导致围绝经期和绝经后女性阴道出血。特别是,由于其对中年女性生活质量的不利影响以及越南等低收入和中等收入国家的医疗保健成本负担,恶性疾病需要进行调查。

目的

因此,通过本研究,我们旨在评估围绝经期和绝经后出血女性中IUPs的主要临床特征。

材料与方法

这是一项于2016年6月至2019年6月在顺化大学医院和顺化中央医院进行的横断面观察性研究。该研究纳入了150名40岁以上有子宫内出血的女性。

结果

研究人群的平均年龄为51.51±7.65岁。围绝经期女性最常见的症状是月经过多,高达62.2%的病例。除子宫内出血外,54.7%的病例至少有一项其他功能性症状,分别为皮肤苍白(35.9%)和下腹痛(31.3%)。子宫内膜增生(EH)是围绝经期和绝经后出血(PMB)两组中最常见的病理类型,分别为66.7%和51.7%。在PMB组中,子宫内膜癌(EC)在EH之后约占38.3%。我们的研究揭示了年龄、月经特征和糖尿病与恶性疾病的关系。其他因素似乎与EC的相关性较小。

结论

月经过多是围绝经期女性最常见的异常子宫出血类型。除阴道出血外,皮肤苍白、盆腔疼痛和疲劳等其他症状也很常见。围绝经期女性住院前的病程天数和失血量显著高于绝经后女性。年龄、月经特征和糖尿病增加了PMB女性患EC的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8b1/10025815/8e00a8133279/JMH-13-225-g001.jpg

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