腔内超声诊断子宫内膜良性病变

Intracavitary Sonography in the Diagnosis of Uterus Benign Edomentrial Disorders

目的 经腔内超声可提高对内膜病变的诊断率。方法 经直肠腔内超声 ,检查前一天晚上口服泻药 ,排出直肠内的粪便。经阴道腔内超声适量充盈膀胱即可。 5 0例内膜良性病变 ,年龄 2 0～ 76岁 ,手术病理证实 47例 ,内膜诊刮证实 3例 ,其中 ,绝经后阴道不规则出血 2 7例 ,占 5 4% ,内膜厚 8～ 45mm。结果 术前超声诊断为内膜癌8例、内膜息肉 14例、子宫肌瘤 3例、宫内膜炎 4例、葡萄胎 1例、内膜良性病变未作明确诊断 2 0例。 10例合并有其他恶性肿瘤 ,乳腺癌 5例 ,术后均口服三苯氧胺 ,每次 10mg ,每日二次 ,内膜厚均 >18mm。 结论 经腔内超声能及早发现子宫内膜病变 ,为妇科针对性诊刮提供了依据。强调对绝经后阴道不规则出血、内膜 >8mm者应做内膜诊刮 ,尤其对乳腺癌术后口服三苯氧胺患者内膜增厚 5～ 8mm时 。

Objective To demonstrate the value of sonography introduced intracavitarily (intravaginal or transrectal).Methods The patients is instructed to take oral laxative the day before sonography.Moderate filling of bladder is necessary.50 patients suffered from uterine bleeding were scanned by sonography and the lesions were all proved to be benign by dilation and curettage (D+C,3) or operation (47). Range of age was 20～76 years.27(54%) patients had irregular postmenopausal uterine bleeding.Nine of these 50 patients had concurrent malignant tumors,five of them had breast cancer and had been on tomoxifin regime (10 mg,bid). Results The thickness of endometrium varied from 8 to 45 mm.All 5 patients with breast cancer had the endometrium≥18mm thick. Conclusion ①Diagnostic D+C is advised for patients with endometrium 5～8mm thick and who had been on protracted tomoxifen regime;②Diagnostic D+C is strongly advised for postmenopausal uterine bleeding patients who have endometrium >8 mm thick;and ③There is a false malignancy probability of 10% (5/50) in sonography,for this,a diagnostic D+C is indicated. [