宫腔镜诊断异常子宫出血280例临床分析

Cinical analysis of hysteroscope in the diagnosis of 280 patients with abnormal uterine bleeding

目的探讨宫腔镜对异常子宫出血的诊断价值。方法对本院280例异常子宫出血患者进行宫腔镜检查,术中定位取材或刮宫。结果经宫腔镜检查后诊断为子宫内膜增厚178例,子宫黏膜下肌瘤12例,子宫内膜息肉12例,宫颈管息肉6例,子宫内膜炎14例,疑似子宫内膜癌18例,子宫内膜异位症4例,宫腔机化组织6例及宫内节育器30例。其中,经宫腔镜诊断为子宫内膜息肉的12例患者中,5例刮宫后经病理检查确诊,其余7例术后经病理检查确诊为子宫内膜息肉;18例疑似子宫内膜癌患者与其病理诊断符合者8例。结论宫腔镜诊断异常子宫出血的准确率高,其敏感性优于B超检查,采用宫腔镜检查以及对子宫内膜异常部位行定位活检可提高异常子宫出血的诊断率,值得在临床中推广使用。

Objective To discuss the diagnostic value of hysteroscope in the diagnosis of abnormal uterine bleeding. Methods 280 cases with abnormal uterine bleedin in our hospital were given hysteroscope inspection and the intraop- erative positioning drawn or curettage. Results By the diagnosis of hysteroscope,178 cases were endometrial thicken- ing,12 cases were submucosal uterine fibroids,12 cases were endometrial polyps,6 cases were cervical polyps,14 cases were endometritis,18 suspected cases were suspected endometrial cancer,4 cases were endometriosis,6 cases were u- terine machine organizations and IUD were 30 cases.Among the I2 patients with endometrial polyps diagnosed by hys- teroscope,5 cases were confirmed after curettage pathology consistent,the rest of 7 cases were received endometrial polyps resection and postoperative pathological examination diagnosed with endometrial polyps,18 suspected cases of endometrial cancer and accorded with its pathological diagnosis in 8 cases. Conclusion Hysteroscope in the diagnosis of abnormal uterine bleeding with high accuracy,the sensitivity is better than B-uhrasound, hysteroscope and endometrial abnormalities parts line biopsy can improve abnormal uterine bleeding diagnosis rate,and it is worth popularizing in clinical use.