213例绝经后子宫出血的宫腔镜检查与治疗

Hysteroscophy of postmenopausal uterine bleeding

目的:评价宫腔镜对绝经后子宫出血的诊断价值。方法 :对 2 13例绝经后子宫出血患者进行宫腔镜检查。 结果 :有阳性发现者为 171例 ,其中老年性子宫内膜炎 68例 ,子宫内膜息肉 3 8例 ,子宫粘膜下肌瘤 2 1例 ,子宫内膜癌 14例 (经定位活检证实 ) ,宫内节育器 (IU D) 8例 ,宫颈管炎 4例 ,宫颈管息肉 18例 ,诊断阳性率 80 .3 %。其中 3例子宫内膜息肉和 2例子宫粘膜下肌瘤行电视宫腔镜下电切术。结论 :宫腔镜检查对绝经后子宫出血诊断阳性率高 ,与定位活检相结合可大大地提高宫腔内疾病诊断的准确性。而且宫腔镜下电切术具有操作简单、病人痛苦少、并发症少。

Objective: To evaluate the diagnosfic value of hysteroscopy to postmenopausal uterine bleeding. Methods: 213 patients with postmenopausal uterine bleeding were examined with hysteroscopy.Results: There were 171 patients had positive findings, among them 68 cases were senile changes, 38 cases endometrial polyp, 21 cases submucous myoma, 14 cases carcimoma of endometrium, 8 cases intrauterine device, 4 cases cervicitis, 18 cases cervical polyp. The positive rate of diagnosis was 80.3%; there were 3 patients with endometrial polyp and 2 paitients with submucous myoma undergone transcervical resection fo polyp(TCRP)or myoma(TCRM).Conclusion: Hysteroscopy is one of effective diagnosis methods for postmenopausal uterine bleeding. It may enhance the diagnostic accuracy about the cause of bleeding within the uterine cavity combined with local biopsy.