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宫腔镜在绝经后子宫出血诊断中的应用价值 被引量:17

Hysteroscopy in diagnosis of postmenopausal uterine bleeding
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摘要 目的:比较宫腔镜检查及诊断性刮宫对绝经后子宫出血(PMB)的诊断价值。方法:回顾性分析177例PMB患者临床资料,按诊查方法分为宫腔镜检查组96例(先行宫腔镜下诊断,再行镜下定位活检)和诊断性刮宫组81例(先行分段诊断性刮宫,再行宫腔镜活检)。比较两者与最终病理结果的符合率。结果:绝经后子宫出血的原因依次为,萎缩性子宫内膜56例(31.6%),子宫内膜息肉36例(20.3%),子宫内膜增生症21例(11.9%),增生/分泌期子宫内膜18例(10.2%),子宫内膜癌17例(9.6%),子宫内膜炎15例(8.5%),子宫黏膜下肌瘤14例(7.9%)。宫腔镜检查组和分段诊断性刮宫组的诊断与病理结果的总符合率为89.6%(86/96)和67.9%(55/81),差异有统计学意义,P<0.05。结论:宫腔镜检查安全可靠,诊断宫腔内病变准确率高,结合镜下定位活检可早期发现子宫内膜癌,优于传统诊刮术,是绝经后子宫出血的首选检查方法。 OBJECTIVE:To compare the value of hysteroscopy and diagnostic curettage in diagnosis of postmenopa- usal uterine bleeding. METHOD: Totally 177 patients with postmenopausal uterine bleeding were analyzed retrospectively with clinical data, 96 patients were divided into the hysteroseopy group which examined by hysteroscopy first and then en- doscopic biopsy,and 81 patients were divided into the diagnostic curettage group which examined by segmented diagnostic curettage frist and then hysteroscopic biopsy. The coincidence rate of diagnosis and pathology was compared between hys- teroscopy group and diagnostic curettage Group. RESULTS: The causes of postmenopausal uterine bleeding were as fol- lows : atrophic endometrium 56 cases (31.6 %), endometrial polyps 36 cases (20. 3 %), endometrial hyperplasia 21 cases ( 11.9 % ), proliferative/secretory phase uterine endometrium 18 cases ( 10.2 % ), endometrial carcinoma 17 cases (9.6 % ), endometritis 15 cases (8.5%),submueous myoma 14 cases (7.9%). The total coincidence rate of hysteroscopy and pa- thology was 89.6 %,while the total coincidence rate of diagnostic curettage and pathology was 67.9 %,and the difference was statistically significant (P〈0.05). CONCLUSIONS: H ysteroscopy is safe,reliable,and accurate in diagnosis of intra- uterine disease,it combined with endoscopic biopsy can detect of endometrial cancer in early stage. Superior to traditional diagnostic curettage,it should be the preferred screening method for postmenopausal bleeding.
出处 《中华肿瘤防治杂志》 CAS 北大核心 2013年第10期775-777,共3页 Chinese Journal of Cancer Prevention and Treatment
关键词 绝经后子宫出血 宫腔镜 诊断性刮宫 诊断 postmenopausal uterine bleeding hysteroscopy diagnostic curettage diagnostic
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