宫腔镜检查诊断子宫异常出血1245例临床分析

Analysis on hysteroscopy in diagnosis of 1245 patients with abnormal metrorrhagia

目的探讨宫腔镜技术诊治子宫异常出血的效果和安全性。方法选取2008年6月—2014年2月我院收治的子宫异常出血患者1 245例,按绝经及婚育史分为:绝经组476例,育龄有妊娠史组537例,育龄未孕组232例。并分别进行宫腔镜检查和治疗。结果 (1)绝经组:检出子宫内膜息肉146例,子宫内膜癌23例,子宫内膜不典型增生15例,子宫内膜复杂增生39例,子宫内膜单纯增生98例,子宫肌瘤26例。宫腔镜阳性诊断率为72.9%。(2)育龄有妊娠史组:检出子宫内膜息肉128例,子宫内膜癌19例,子宫内膜不典型增生17例,子宫内膜复杂增生48例,子宫内膜单纯增生86例,子宫肌瘤36例,胚物残留5例,宫腔镜阳性诊断率为63.1%。(3)育龄未孕组:检出子宫内膜息肉101例,子宫内膜癌6例,子宫内膜不典型增生8例,子宫内膜复杂增生6例,子宫内膜结核8例,宫腔镜阳性诊断率为55.9%。结论宫腔镜检查技术的临床应用对于子宫异常出血患者的诊断及指导治疗有重要意义。

Objective To discuss the safety and efficacy of hysteroscopy in diagnosis of metrorrhagia. Methods A total of 1 245 patients with metrorrhagia admitted from June 2008 to February 2014 were divided into 3 groups, i.e. postmenopausal group （ n = 476 ） , gestational age and ever pregnant group （ n = 537 ） and gestational age and never pregnant group （ n = 232 ）. They underwent hysteroscopy and treatment. Results （ 1 ） In postmenopausal group,there were 146 cases of endometrial polyps,23 cases of endometrial carcinoma, 15 cases of atypical hyperplasia, 39 cases of complex hyperplasia,98 cases of simple hyperplasia, and 26 cases of uterine myoma. The positive diagnosis rate was 72.9%. （2） In gestational age and ever pregnant group, there were 128 cases of endometrial polyps, 19 cases of endometrial carcinoma, 17 cases of atypical hyperplasia, 48 cases of complex hyperplasia, 86 cases of endometrial hyperplasia, 36 cases of uterine myoma and 5 cases of missed abortion. The positive diagnosis rate was 63.1%. （3） In gestational age and never pregnant group, there were 101 cases of endometrial polyps, 6 cases of endometrial carcinoma, 8 cases of atypical hyperplasia, 6 cases of complex hyperplasia, and 8 cases of endometrial tuberculosis. The positive diagnosis rate was 55.9%. Conclusion Hysteroscopy is an effective and safe method for patients with abnormal metrorrhagia to identify the causes and guide treatment.