宫腔镜检查与治疗绝经后子宫出血80例临床分析

Clinic Analysis of 80 Cases of Hysteroscope and Postmenopause Uterine Bleeding

目的评价宫腔镜对绝经后子宫出血的诊断及治疗价值。方法总结80例绝经后子宫出血患者应用宫腔镜检查与治疗的临床资料,着重与病理学检查结果作对照分析。结果80例患者中有62例阳性发现,其中萎缩性子宫内膜28例,子宫内膜不规则增生11例,子宫内膜息肉8例,子宫颈管息肉4例,子宫黏膜下肌瘤4例,宫内节育器3例,颈管炎2例,子宫内膜癌2例。诊断阳性率为77.5%。其中子宫内膜息肉、颈管息肉、子宫黏膜下肌瘤及颈管炎行宫腔镜下电切手术。结论宫腔镜检查对绝经后子宫出血诊断阳性率高,与定位活检结合可明显提高宫腔内疾病诊断的准确率,而且宫腔镜下电切术使可保守治疗的患者避免剖腹探查或子宫切除,并具有患者痛苦小、术后恢复快的优点。

Objective To evaluate the diagnostic and therapeutic value of hysteroscope in postmenopause uterine bleeding. Method The clinic data of 80 patients who underwent hysteroscopy due to postmenopause uterine bleeding were summarized, the comparative analysis focus on the pathological examination results. Results There were 62 positive findings in 80 patients. Among them,endometrial atrophy was found in 28 cases, endometrial dysplasia was in 11 cases, endometrial polyp was in 8 cases,cervical canal.polyp was in 4 cases,submucous myomas was in 4 cases, and intrauterine device was in 3 cases, cervical canal inflammation was in 2 cases, carcinoma of endometrium was in 2 cases. The rate of positive diagnosis was 77.5%. The patients suffering from endometrial polyp,cervical canal polyp, submucous myomas, and cervical canal inflammation underwent transcervical resection. Conclusion It is a high diagnostic positive rate of hysteroscope in postmenopause uterine bleeding. The combined use of directed biopsies could greatly enhance the diagnostic accuracy of disease in uterine, and the transcervical resection could make the patients that could be conservative therapy avoiding laparotomy and hysterectomy. Furthermore,it has the advantage of less pain and faster restore after operation.