宫腔镜及病理检查对绝经后子宫出血的病因诊断价值

目的:探讨宫腔镜(Hysteroscopy,HS)检查对绝经后子宫出血(postm enpausal b leed ing,PMB)的病因诊断价值。方法:应用宫腔镜检查绝经后子宫出血患者192例,术中同时定位取材做病理检查。结果:宫腔镜诊断子宫内膜癌的敏感性为80.00%,子宫黏膜下肌瘤100.00%,萎缩性子宫内膜91.76%,子宫内膜息肉68.18%,子宫内膜炎70.00%,子宫颈管息肉100.00%,子宫内膜增生过长73.91%;宫腔镜下定位活检准确率为81.77%。结论:宫腔镜检查是PMB患者首选的检查方法,可直视下观察子宫内膜形态变化,结合病理检查是早期诊断宫腔病变的最佳手段。

The evaluation of hysteroscopy and pathology in diagnosis of postmenopausal uterine hemorrhage

Objective:To evaluate hysteroscopy in the diagnosis of the cause of postmenopausal uterine hemorrhage.Methods:192 cases with postmenopausal uterine hemorrhage were examined by panoramic hysteroscopy with curettage or endometrial biopsy done at the same time.Results:The sensitivity of pathology and hysteroscopy in diagnosis of endometrium carcinoma was 80.00%,in submucous myoma was 100%,in atrophic endometrium was 91.76%,in endometrium polyp was 68.18%,in endometritis was 70.00%,in hyperplusia of endometrium was 73.91%,in cervix polyp was 100%.The accuracy of pathology alive through hysteroscopy was 81.77%.Conclusion:Endometrium can be directly seen with hysteroscopy,the combination of hysteroscopy with uterine curettage and pathological examination is an optimal method in early diagnosis of the cause of postmenopausal uterine hemorrhage.