宫腔镜检查异常子宫出血202例临床分析

Clinical Analysis on 202 Cases with Abnormal Uterine Bleeding Diagnosed by Hysteroscopy

目的探讨阴道B超、宫腔镜检查在诊断异常子宫出血中的临床应用价值。方法选择2004年2月—2006年2月在我院门诊就诊的202例异常子宫出血患者常规阴道超声检查后行宫腔镜检查,同时宫腔镜下定位活检或诊刮进行病理组织学检查。结果术前B超检查宫腔内异常发生率为51.49%。宫腔镜发现宫内占位病变及形态异常共184例,占91.09%。取子宫内膜行病理学检查,病理结果异常166例,占82.18%。结论宫腔镜检查能直视宫腔内病变,定位取材,诊断准确率高,可作为诊断异常子宫出血的重要手段,但宫腔镜检查不能取代子宫内膜病理组织学检查。

Objective To investigate the clinical value of transvaginal B ultrasound and hysteroscopy in the diagnosis of abnormal uterine bleeding. Methods Retrospectively analyze 202 cases who were preliminarily diagnosed abnormal uterine bleeding from Feb 2004 to Feb 2006. For all the cases, uhrasonography had been done before hysteroscopy, diagnostic curettage had been done to all the EP patients, all the patients received endometrial electrosection through hysteroscope, and pathological examination after operation. Results 51.49% cases were reported abnormal by B ultrasound. 184 cases （91.09%） were diagnosed abnormal by hysteroscopy. 166 cases （82.18%） were reported abnormal by pathological report after endometrial curettage. Conclusions Hysteroscopy diagnosis is an important diagnostic method for abnormal uterine bleeding because of its intuitionistic diagnosis, accurate localizational endometrial curettage and highly specific diagnosis. But the hysteroscopy can not replace tissue pathological examination of endometrial curettage.