45例妊娠期阴道出血患者阴道镜图像特征及其处理

The pictorial features of the colposcopy and the treatment in 45 pregnancy cases with vaginal bleeding

目的评价阴道镜对妊娠期阴道流血患者宫颈病变的诊断价值。方法对45例非产科原因阴道流血的患者进行了电子阴道镜检查,分析其镜检特征。结果正常转化区19例,其中宫颈炎伴活动性出血9例,宫颈炎无活动性出血10例;宫颈蜕膜异位3例;低度子宫颈鳞状上皮内病变(low-grade squamous intraepithelial lesion,LSIL)5例;高度子宫颈鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)1例;宫颈赘生物17例,其中7例坏死,3例湿疣样改变。结论妊娠期不规则阴道出血原因复杂,阴道镜检查能较快判断其宫颈病变性质,指导临床正确处理。

Objective To evaluate the value of electronic colposcope （EC） in the diagnosis of vaginal bleeding during pregnancy through analyzing the pictorial features and the follow-up. Methods Forty-five patients with gestational period vaginal bleeding except for non-obstetric reasons were examined by electronic colposcope from January 2006 to March 2009. Results The results showed that normal transformation zone were 19 cases including 9 cases of cervicitis with active bleeding and 10 cases of cervicitis without active bleeding; cervical deciduomatosis were 3 cases; low-grade squamous intraepithelial lesion（LSIL） were 5 cases; high-grade squamous intraepithelial lesion（HSIL） was 1 case; cervical vegetation 17 cases including the necrosis in 7 cases and the condyloma-like lesions in 3 cases. Conclusion The reason of abnormal vaginal bleeding during pregnancy was complicated while electronic colposcope could find the character of cervical lesion quickly and guide the clinical treatment.