宫腔镜在诊断绝经期老年妇女绝经后子宫出血或超声宫腔异常中的.doc

宫腔镜在诊断绝经期子宫出血或超声宫腔异常中的临床价值 陈丽群 （上海第一人民医院分院妇科） 毛文娟（上海第一人民医院分院B超室）200081 [摘要] 目的 探讨绝经后老年妇女子宫内膜良恶性病变的特点。 方法 2008年12月~2012年1月我院177例老年妇女因绝经后子宫出血或超声提示宫腔异常入院。本文回顾分析146例子宫内膜病变的特点。结果 经宫腔镜检查与病理诊断，146例患有子宫内膜良恶性病变，31例子宫内膜正常。子宫内膜良性病变132例，包括子宫内膜息肉62例（42.47%）、宫颈管息肉16例（10.96%）、萎缩性子宫内膜炎10例（6.85%）、宫颈息肉合并子宫内膜息肉12例（8.22%）、宫腔粘连8例（5.48%）、子宫内膜不典型增生4例（2.74%）、子宫内膜增生期改变15例（10.27%）、粘膜下子宫肌瘤3例（2.05%）、宫颈肌瘤1例（0.68%）、复杂性子宫内膜增生过长1例（0.68%）、子宫内膜腺癌14例（9.59%），内膜腺癌术后病理分级为Ⅰa—Ⅱb。 结论 本资料的38个月我院共作了453例宫腔镜检查，绝经后207例（46%），因绝经后子宫出血或超声提示宫腔异常而入院的为177例。绝经后老年妇女的子宫内膜病变主要是子宫内膜息肉、子宫内膜腺癌、萎缩性子宫内膜炎、宫腔粘连。 [关键词] 宫腔镜；绝经期；子宫内膜病变；早诊断；早治疗 The clinical value of Hysteroscopy in the diagnosis of menopause with uterine bleeding or abnormal ultrasonographical findings Cheng LiQun Branch of Shanghai First People”s Hospital Gynecology Dept 200081 Mao WenJuan Branch of Shanghai First People”s Hospital B-Ultrasound Room 200081 [Abstract] Objective To explore the characteristics of benign or malignant endometrial disease in elderly postmenopausal women. Methods The clinical data of 177 elderly women who suffered from postmenopausal bleeding or abnormal ultrasonographical findings in the uterus were enrolled from December 2008 to January 2012. In this paper, we retrospectively analyze the characteristics of 146 cases with endometrial disease. Results All of the patients underwent hysteroscopic diagnosis and treatment in our hospital, 146 of the cases were diagnosed with endometrial disease, and the other 31 showed normal endometrium. In the 132 benign endometrial disease, endometrial polyps was detected in 62 cases(42.47%), endocervial canal polyp in 16 (10.96%), atrophic endometritis in 10(6.85%), cervical polyps and endometrial polyps in 12(8.22%), intrauterine adhesions in 8(5.48%), endometrial atypical hyperplasia in 4(2.74%), endometrial hyperplasia period change in 15(10.27%), sub mucous myomas in3(2.05%), cervical myomas in 1(0.68%), complex endometrial hyperplasia in 1(0.68%), endometrial adenocarcinoma in 14(9.59%