微型吸管在子宫异常出血中初步筛查的价值

Evaluation of mini suction tube in preliminary screening of abnormal uterine bleeding

目的了解微型吸管在子宫异常出血中初步筛查的价值。方法采用直径4．4mm微型吸管和常规刮匙获取子宫内膜标本，送病理检查进行比较。结果直径4．4mm微型吸管在宫颈扩张、手术并发症、疼痛方面优于常规诊刮，有显著性差异（，值分别为86．16、84．41，t=-13．03；均P〈0．01）。在病理对照方面：两组病理检验一致率为96．02％（579／603）；微型吸管获取有效标本取样率为87．06％（525／603），诊刮组获取有效标本取样率为87．73％（529／603），两组比较无显著性差异（χ2=0．12，P=0．729）。微型吸管筛查结果：有34．83％（210／603）的患者术后月经恢复正常，未治疗；有38．064％（233／603）的患者术后经药物治疗月经恢复正常，有22．72％（137／603）的患者再次宫腔镜检查；3．81％（23／603）的患者因子宫内膜癌和癌前病变手术治疗。结论微型吸管是一种价廉、简便易行、患者痛苦少、准确性高的检查子宫异常出血的初步筛查方法，尤其对子宫内膜癌和癌前病变有较高的敏感性。

Objective To understand the value of mini suction tube in preliminary screening of abnormal uterine bleeding. Methods Endometrial specimens were obtained with mini suction tube with diameter of 4.4mm and conventional curette, and the histopathology results were compared. Results Mini suction tube obtained better effects than curette in dilation of cervical canal, complication of procedure , significant （χ2 value 86.16 and 84.41, respectively, t = - 13.03, all P 〈 0.01 ）. The and pain and the differences were statistically was coincidence rate of pathological results of two groups was 96.02% （579/603）. Among specimens obtained with mini suction tube, 87.06% （525/603）were effective, and the effective rate was 87.73% （529/603）in diagnostic curettage group. The difference was not significant （χ2 =0.12,P =0. 729）. After screened with mini suction tube, 34.83% （210/603） patients had normal menstruation after operation and without any treatment, 38.64% （233/603） regained normal regular menstruation after medication, 22.72% （ 137/603 ） underwent hysteroscopy, and 3.81% （23/603） underwent operation because of endometrial cancer and precancerous lesions. Conclusion The mini suction tube is a cheap and convenient device for preliminary screening of abnormal uterine bleeding with little pain and high accuracy. It is especially sensitive to endometrial cancer and precancerous lesions.