宫腔镜联合超声检查诊断149例绝经后妇女宫内病变临床分析

Clinical analysis of 149 cases of endometrial abnormalities of postmenopausal women diagnosed by combination of ultrasonography and hysteroscopy.

目的:探讨宫腔镜联合超声检查对绝经后妇女宫腔内病变的诊断价值。方法:应用宫腔镜联合超声检查对149例绝经后妇女宫腔内病变进行检查,术前均行超声,术中定位取材或诊断性刮宫术。结果:在149例病例中,宫腔镜联合超声检查诊断黏膜下肌瘤20例,与病理诊断符合率100.0%;子宫内膜息肉49例,与病理诊断符合率100.0%;萎缩性内膜炎31例,与病理诊断符合率81.6%;子宫内膜增生13例,与病理诊断符合率61.9%;子宫内膜癌13例,与病理诊断符合率92.9%。结论:对绝经后子宫内膜病变的病因诊断中,宫腔镜联合超声检查提高了子宫内膜息肉及黏膜下肌瘤的诊断率。对子宫内膜增生症和子宫内膜癌的诊断,因可以镜下定位诊刮,亦提高了诊断率。宫腔镜联合超声检查对宫内病变的诊断率及治疗具有重要的诊断价值,值得推广应用。

Objective：To investigate the clinical value of the combination of ultrasonography and hysteroscopy in the diagnosis of endometrial abnormalities of postmenopausal women.Methods：The endometrial abnormalities of 149 cases of postmenopausal women were examined by ultrasonography and hysteroscopy followed by the dilation and curettage.Results：Twenty cases of women were diagnosed as submucous myoma,49 cases endometrial polyp,49 cases atrophic endometritis,13 cases endometrial hyperplasia and 13 cases endometrial carcinoma by pathologists.Conclusion：The combination of ultrasonographic scanning and hysteroscopic examination improved the diagnosis of the endometrial abnormalities by postmenopausal women,although the diagnosis of endometrial hyperplasia and endometrial cancer must be confirmed by pathologists.The exact sampling of endometrial tissue was improved also by the ultrasonographic examination and hysteroscopic diagnosis.The combination of the ultrasonographic scanning and hysteroscopic examination should be applied in the diagnosis and management for the abnormal endometriums in postmenopausal women.