超声和宫腔镜检查在219例绝经后子宫出血中的诊断价值

Diagnostic value of ultrasonography and hysteroscopy in 219 cases postmenopausal uterine bleeding

目的探讨宫腔镜及B超检查在绝经后子宫出血病因中的诊断价值。方法对我院2001年8月至2011年8月219例绝经后子宫出血妇女的临床资料及宫腔镜检查的病理结果进行回顾性分析。结果以病理诊断为基础,宫腔镜诊断子宫内膜增生症、子宫内膜炎、子宫粘膜下肌瘤、子宫内膜息肉、子宫内膜癌与病理诊断的符合率分别为60.8%(48/79)、91.9%(34/37)、90.9%(20/22)、93.1%(27/29)、80.0%(20/25),超声检查的符合率分别为48.1%(38/79)、35.1%(13/37)、59.1%(13/22)、65.5%(19/29)、44.0%(11/25)。宫腔镜诊断与病理诊断的符合率为78.1%(171/219),明显高于超声诊断与病理诊断的符合率48.9%(107/219)(χ2=40.334,P=0.01)。结论绝经后子宫出血的患者最佳诊断方法是,先做超声检查了解子宫及盆腔情况,再宫腔镜检查后行分段诊刮术做组织病理学检查确诊。

Objective To study the diagnostic value of ultrasonography and hysteroscopy in postmenopausal uterine bleeding.MethodsThe clinical data and pathologic results of 219 cases of postmenopausal uterine bleeding from August 2001 to August 2011 were retrospectively analyzed.Results The correspondence between pathology and hysteroscopy in endometrial hyperplasia,endometritis,submucous myoma,endometrial polyp,endometrial carcinoma were 60.8%（48/79）,91.9%（34/37）,90.9%（20/22）,93.1%（27/29）,80.0%（20/25）,the correspondence between pathology and ultrasonography was 48.1%（38/79）,35.1%（13/37）,59.1%（13/22）,65.5%（19/29）,44.0%（11/25）.The correspondence in hysteroscopy was obviously higher than that in ultrasonography（χ2=40.334,P=0.01）.Conclusions IT should be the best diagnostic method for patients with postmenopausal uterine bleeding to have ultrasonography to know the condition of the uterus and the pelvic first,and then conduct dilation and curettage and make histopathological examination after hysteroscopy.