宫腔镜在绝经后子宫出血中临床应用价值.docVIP

宫腔镜在绝经后子宫出血中临床应用价值 　 作者：魏莉从，张风格，卢玉莲，李兰芬 【关键词】 绝经后期；子宫出血；宫腔镜检查；子宫内膜肿瘤 　　【摘要】 目的 评价宫腔镜对绝经后子宫出血的诊断和治疗价值，进一步证实宫腔镜是绝经后出血的最佳检查手段。方法 对126例绝经后子宫出血患者进行宫腔镜检查，其中49例同时行宫腔镜下手术。结果 萎缩性子宫内膜36例，子宫内膜息肉19例，宫颈管息肉9例，子宫黏膜下肌瘤9例，子宫内膜增生过长18例，子宫内膜癌10例，子宫内膜不典型增生12例，其他13例。绝经后子宫出血宫腔镜诊断与病理诊断符合率78.57%。对其中30例行宫腔镜直视下手术，19例行电视宫腔镜下电切术。结论 宫腔镜对绝经后子宫出血的诊断和治疗具有实用价值，诊断阳性率高，不易漏诊。同时，选择合适病例行镜下手术，具有操作简单、病人痛苦小、并发症少、术后恢复快的优点。 【关键词】 绝经后期；子宫出血；宫腔镜检查；子宫内膜肿瘤 Value of hysteroscopy for patients with postmenopausal uterine bleeding 【Abstract】 Objective To evaluate the value of hysteroscopy in diagnosis and treatment of postmenopausal uterine bleeding,to form that hysteroscopy is the best way to examine postmenopausal uterine bleeding.Methods The author used the diagnostic technique of hysteroscopy and direct biopsies to analyse the causes of postmenopausal bleeding of 126 patients,among which 49 patients was operated at the same time.Results The results showed that atrophic endometrium（36 cases） was the most mommon cause of postmenopausal bleeding,and endometrial hyperplasia（18 cases）、atypical endometrial hyperplasia（12 cases）、submucousl eiomyoma（9 cases）,endometrial polyp（28 cases） were also common in the patients with postmenopausal bleeding.There were 10 endometrial carcinomas.The coincident rate between hysteroscopy and directed biopsies was 78.57%.Conclusion So the use of hysteroscopical technique is of great significance in finding out the causes of postmenopausal bleeding,making a definite diagnosis of endometrial carcinoma and precancerouslesion,and further preventing the occurrence of endometrial carcinoma.The examination of hysteroscopy is an effective and valuable method for diagnosing postmenopausal bleeding. 【Key words】 postmenopause;uterine hemorrhage;hysteroscopis;endometrial neoplasms 绝经后子宫出血是指绝经1年后出现阴道流血。随着人类的寿命不断延长，绝经后子宫出血越来越多地成为临床常见病症。出血的原因有多种，传统的诊断方法系采用诊断性刮宫。但因其为盲性操作，往往致取材不准确，常有10%~35%病变被遗漏［1］。超声波检查仅能提供影像学图像，对直径2cm以下的息肉与肌瘤分辨不清，无法直接准确地判断宫腔内病变。而宫腔镜的临床应用为这一领域开辟了一个新的纪元。现将我院应用宫腔镜检查及治疗绝经后出血的结果总结如下。