宫腔镜检查对子宫出血诊断方面的临床应用

Clinical Application of Womb Endoscope Examination in Diagnosing Uterine Bleeding

目的:了解子宫内部病变,提高诊断准确率。方法:对113例子宫异常出血患者行宫腔镜检查并针对检查结果作出相应治疗。结果:本组阳性率72.79%。绝经后子宫出血6例中3例子宫内膜癌,非绝经期异常子宫出血94例中22例子宫内膜增生,10例黏膜下肌瘤或壁间内突型肌瘤,18例子宫内膜息肉,6例节育环异常,病理活检阳性69.85%。65例宫腔镜检查前行B超检查,23例异常(16.91%);镜检异常45例(69.23%)。结论:宫腔镜检查直视宫腔,有助于鉴别子宫内功能性或器质性病变,对可疑病灶在直视下取材活检,诊断准确率高,优于B型超声检查。

Objective： To study and analyze the pathological changes inside the womb in order to obtain higher diagnostic accuracy. We have examined 113 sufferers with abnormal or bleeding wombs by womb endoscope, and cure them respectively based on the examination results. It is proved that the masculine rate accounts for 72.79%. Three of the six cases which show the symptom of abnormal womb bleeding during the menopause are caused by womb internal membrane cancer. Among the 94 cases/hat indicate abnormal womb bleeding during the nonmenopause, 22 cases are caused by womb internal membrane hyperplasia, l0 by sinew tumor under the mucous membrane or inward - protrusive sinew tumor, 18 by polypns of the womb internal membrane, and six by abnormal conception control loop. The pathological examination reveals that the masculine rate reaches 69.85%. There are 65 cases that went through Type B ultrasonic inspection before the endoscope examination, 23 of which indicate abnormity （ 16.91% ）. However, the abnormal cases found out during the endoscope examination amount to 45 （69.23%）. The conclusion derived from our study is that the womb endoscope can examine the womb directly and conduce to find out the functional or organic diseases inside the womb. Therefore, to examine the alive cells directly with the help of womb endoscope is better than the Type B ultrasonic inspection for obtaining higher diagnostic accuracy.