宫腔镜对异常子宫出血原因诊治的临床评价

目的探讨宫腔镜诊治异常子宫出血原因的临床应用价值.方法 260例异常子宫出血患者,随机分为宫腔镜组及对照组各130例.宫腔镜组应用宫腔镜检查,镜下直视定位取材或定位诊断性刮宫送病理检查;对照组130例行传统的诊断性刮宫术.两组结果异常者均应用宫腔镜手术治疗.结果宫腔镜组130例患者,宫腔镜下有异常发现126例,检出率为96.92%,余4例病理检查示子宫内膜轻度增生,宫腔镜下未发现异常.120例经相应宫腔镜手术治疗后,均治愈,治愈率95.23%,6例子宫内膜不典型增生及局部癌变患者开腹行子宫切除术也均治愈.对照组130例患者中,有异常发现92例,检出率为70.76%;无异常38例.92例经病理活检确诊异常者,经宫腔镜手术治疗后,治愈67例,治愈率72.83%,余25例治疗后子宫异常出血无改善,与未发现异常的38例行宫腔镜检查联合病理活检,检出子宫内膜息肉30例,黏膜下肌瘤15例,子宫腺肌病9例,宫内膜不典型增生及局部癌变4例,漏诊率44.61%（58/130）;余5例病理检查示子宫内膜轻度增生,宫腔镜下未发现异常.漏诊的58例中,54例均在宫腔镜下行相应手术治疗,术后均获治愈,4例子宫内膜不典型增生及局部癌变患者开腹行子宫切除术也均治愈.宫腔镜组的检出率及治愈率均明显高于对照组（P〈0.05）.两组宫腔镜手术均未见明显并发症.结论宫腔镜诊治异常子宫出血安全、有效.

The Clinical Application of Hysteroscopy in Diagnosis and Treatment of Abnormal Uterine Bleeding

Objective To study the clinical value of hysteroscopy in diagnosis and treatment of abnormal uterine bleeding.Methods 260 patients with abnormal uterine bleeding were randomly divided into two groups,130 patients in each group,hysteroscopy group and control group.130 patients in hysteroscopy group were treated under hysteroscopy,through pathological examination by locating sampling under hysteroscopy or curettage,and traditional curettage diagnosis was given to 130 cases in control group.Hysteroscop surgica...