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            <td height="30" colspan="2" class="main_ArticleTitle" style="word-break:break-all;Width:fixed">出血是子宫癌的常见及早期症状吗?</td>
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            <td colspan="2" bgcolor="FFE3F3"> 更新时间:2008-6-18 16:22:07  【字体:<a href="javascript:fontZoomA();" class="top_UserLogin">小</a> <a href="javascript:fontZoomB();" class="top_UserLogin">大</a>】</td>
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<p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 由于更年期排卵可能不规律,故多数妇科医生认为绝经后出血的最好定义应是&#8220;发生于最后一次出血后至少1年的任何出血&#8221;。约20%的绝经后出血是由盆腔肿瘤所致。<br />
  最常见症状为异常的子宫出血。国内、外文献报道其发生率为88%~96%。最多见于绝经期或绝经后出血,表现为血性分泌物或不规则阴道流血。一次出血也可能仅持续1~2天,几个月不复发。由于更年期排卵可能不规律,故多数妇科医生认为绝经后出血的最好定义应是&#8220;发生于最后一次出血后至少1年的任何出血&#8221;。约20%的绝经后出血是由盆腔肿瘤所致。</p>
<p>  约10%患者(国内有学者报道为47.70%)在阴道流血前有浆液性阴道排液;若肿瘤坏死并有感染时,则为恶臭的排液。颈管堵塞时,可以形成宫腔积脓。</p>
<p>  若出血发生在绝经前,可表现为功能失调性子宫出血。所以对于更年期出血的患者,不能单纯认为是内分泌失调所致的良性疾患,而应常规刮取子宫内膜标本以排除恶性病变。临床资料表明,绝经前患功能性出血者后来有较高的宫体癌发生率;绝经后发生宫体癌者比对照组有更高的绝经前功能性出血发生率;绝经前发生宫体癌者以往有明显高的功能性出血发生率。</p>
<p>  晚期患者可出现下腹痛、腰痛、贫血及恶病质。</p>
<p>  在接受雌激素治疗绝经后症状的宫体癌患者中,约20%是无症状的。因此在制订雌激素治疗计划前应做子宫内膜活检以排除增生或癌,且应对这些妇女定期(间隔1年)进行子宫内膜的病理学监测。</p>
<p>  早期宫体癌患者盆腔检查无明显异常。子宫体大小和性状往往正常(约占40%)。子宫体的增大在一定程度上取决于肿瘤的扩散,但更多取决于所伴有的肌瘤或宫腔积脓,多数病例宫腔越大,预后越差。对有上述症状的绝经后妇女,检查发现子宫体萎缩不明显,反显饱满或有宫腔积脓时,则应疑及此病。宫腔积脓时,由于感染及宫腔压力增加而有利于癌的早期侵蚀肌层。</p>
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