背景:出现异常子宫出血的妇女需要仔细和彻底的评估,包括子宫内膜的超声检查和子宫内膜组织的组织病理学评估。这项横断面研究的目的是确定在阴道镜诊所使用MedGyn®移液管对不丹妇女进行子宫内膜取样后子宫内膜组织不足的比率和相关因素,JigmeDorjiWangchuck国家转诊医院(JDWNRH),不丹.
方法:这项横断面研究是在阴道镜诊所进行的,JDWNRH,十月之间的廷布,2021年3月,2022年。本研究中包括的女性使用MedGyn®移液管进行子宫内膜取样,无需麻醉作为办公室程序。使用面试官管理的问卷收集数据,并将结果提取到结构化的形式中。组织病理学报告是从病理学和实验室医学系提取的,JDWNRH使用研究参与者的独特不丹公民身份证号码。
结果:发现27%的子宫内膜组织不足(122例中有33例)。在89例子宫内膜组织充足的患者中,30例(33.7%)组织学结果正常,良性病理22例(24.7%),萎缩10人(8.2%),增生27例(30.3%)。在单变量分析中,绝经状态(OR1.6,95%CI0.708-3.765),超重和肥胖(OR1.695%CI0.640-3.945),失业者(OR1.7,95%CI0.674-1.140),未产(OR1.7,95%CI0.183-15.816),初产妇(OR5.1,95%CI0.635-40.905)和使用激素避孕(OR2.1,95%CI0.449-10.049)与子宫内膜组织不足的风险增加相关.在多元回归分析中,无效平价(OR1.1,95%CI0.101-12.061),超重和肥胖(OR1.4,95%CI0.490-3.917),使用激素避孕药(OR2.2,95%CI0.347-13.889),和初级外科医生(OR1.1,95CI0.463-2.443)被发现与子宫内膜组织不足相关.然而,上述相关性无统计学意义(p>0.05)。
结论:使用MedGyn®移液管进行子宫内膜取样后,子宫内膜组织不足的发生率为27.0%。与子宫内膜取样后子宫内膜组织不足风险增加相关的因素是绝经状态,超重和肥胖,失业,未产,初产妇和使用激素避孕。
BACKGROUND: Women presenting with abnormal uterine bleeding needs careful and thorough assessment including ultrasound examination of endometrium and histopathological assessment of the endometrial tissues. The objective of this cross-sectional
study was to determine the rate and the factors associated with inadequate endometrial tissues after endometrial sampling using MedGyn® pipette among Bhutanese women at the colposcopy clinic, Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Bhutan.
METHODS: This cross-sectional
study was conducted at the colposcopy clinic, JDWNRH, Thimphu between October, 2021 and March, 2022. Women included in this
study underwent endometrial sampling using MedGyn® pipette without anesthesia as an office procedure. Data were collected using an interviewer-administered questionnaire and results extracted into a structured pro forma. The histopathology reports were extracted from the Department of Pathology and Laboratory Medicine, JDWNRH using the unique Bhutanese citizenship identity card number of the
study participants.
RESULTS: Inadequate endometrial tissues were noted in 27% (33 out of 122 cases). Among 89 patients with an adequate endometrial tissue, histologic results were normal in 30 (33.7%), benign pathology in 22 (24.7%), atrophy in 10 (8.2%), and hyperplasia in 27 (30.3%). In a univariate analysis, menopausal state (OR 1.6, 95% CI 0.708-3.765), overweight and obese (OR 1.6 95% CI 0.640-3.945), unemployed (OR 1.7, 95% CI 0.674-1.140), nulliparous (OR 1.7, 95% CI 0.183-15.816), primipara (OR 5.1, 95% CI 0.635-40.905) and use of hormonal contraception (OR 2.1, 95% CI 0.449-10.049) were associated with increased risk of inadequate endometrial tissues. On multivariate regression analysis, nulliparity (OR 1.1, 95% CI 0.101-12.061), overweight and obesity (OR 1.4, 95% CI 0.490-3.917), use of hormonal contraceptives (OR 2.2, 95% CI 0.347-13.889), and junior surgeons (OR 1.1, 95%CI 0.463-2.443) were found to be associated with inadequate endometrial tissues. However, the above associations were not statistically significant (p > 0.05).
CONCLUSIONS: The rate of inadequate endometrial tissue following endometrial sampling using MedGyn® pipette was 27.0%. Factors associated with an increased risk of inadequate endometrial tissue after endometrial sampling were menopausal state, overweight and obese, unemployed, nulliparous, primipara and use of hormonal contraception.