宫腔镜诊断与治疗绝经后子宫出血90例临床分析

Value of hysteroscopy on diagnosis and treatment of post menopausal uterine bleeding

目的:探讨宫腔镜对绝经后异常子宫出血的诊断及治疗价值。方法:对90例绝经后出血的患者进行宫腔镜检查,分析导致绝经后出血的宫腔内因素。对镜下诊断为子宫粘膜下肌瘤、子宫内膜息肉、子宫颈肌瘤及息肉的47例行宫腔镜手术治疗,9例子宫内膜癌患者接受开腹手术,并最终获得组织病理诊断。随诊观察手术疗效。结果:绝经后异常子宫出血的原因以子宫腔内良性占位病变居首位(子宫内膜息肉27例,子宫粘膜下肌瘤7例,宫颈管息肉13例)共47例,其次是萎缩性子宫内膜炎共31例,子宫内膜癌为第3位共9例。绝经后良性宫腔占位47例均采用宫腔镜手术治疗,手术时间短,创伤小,术后恢复快,无一例手术并发症。结论:宫腔镜检查直观准确,是绝经后异常子宫出血病因检查的首选方法;宫腔镜手术创伤小、疗效高,是目前治疗绝经后宫腔良性占位所致异常子宫出血的最佳方法。

Objective： To evaluate hysteroscopy in diagnosis and treatment of postmenopansal bleeding. Methods： 90 cases of postmenopausal bleeding were examined used hysteroscopy. 47 patients who suffered myoma or polypus were underwent electroresection through hysteroscopie operation, another 9 patients received trans-abdominal hysterectomy as endometrial carcinoma Results： Etiology to causing postmenopausal uterine bleeding included endometrial polypus, submucosa myoma, cervix polypus, endometritis, and endometrial carcinoma. The benign lesion in uterine cavity could be treated efficiency by hysteroscopic operation. Conclusion： Hysteroscopic examination is the best way for diagnosis of postmenopausal uterine bleeding, and hysteroscopic operation is the best way for treatment the benign lesion in uterine cavity.