宫腔镜诊断异常子宫出血488例分析

Hysteroscopic diagnosis for abnormal uterine bleeding with an analysis of 488 cases

目的:探讨宫腔镜诊断异常子宫出血的效果。方法:应用宫腔镜检查异常子宫出血488例,术中定位取材或诊断性刮宫。结果:异常子宫出血类型及病理诊断符合率分别为:子宫内膜增生119例,93.7%(119/127),子宫内膜息肉104例,98.1%(104/106),粘膜下肌瘤85例,100%(85/85),子宫内膜炎76例,96.2%(76/79),宫内节育器41例,萎缩性内膜22例,95.6%(22/23),宫内胚物残留16例,100%(16/16),子宫内膜癌10例,90.9%(10/11)。结论:宫腔镜可发现宫腔内病变并对可疑病灶取材活检,使宫腔内病变的诊断更直接、准确。

Objective：To explore the value of hysteroscopy on diagnosis of abnormal uterine bleeding. Methods：488 cases of abnormal uterine bleeding were examined by hysteroscope. During the operation all the patients were taken biopsy or curettaged of uterus. Results ：The types of abnormal uterine bleeding were endonetrial hyperplasia, endometrialpolys, submucosa myoma, endometritis, IUD, atrophica endometrium remains of embryo in the uterus and endometrial carcinoma which were diagnosed in 127 cases, 106 cases, 85 cases ,79 cases ,41 cases,23 cases, 16 cases, and 11 cases respectively. The diagnostic coincident rate of hysteroseopy with pathological examination 93.7% （ 119/127 ） ,98.11% （ 104/106）, 100% （ 85/85 ）, 96.20% （ 76/79 ）, 95.65% （ 22/23 ）, 100% （ 16/16 ） , and 90.90% （ 10/11 ）. Conclusions： The focus of disease in the uterine cavity can be discovered and taken biopsy by hysteroscopy, which make the diagnosis more directly and correctly.