宫腔镜诊断与治疗绝经后子宫出血的临床评价

目的:探讨宫腔镜对绝经后子宫出血的诊断及治疗价值。方法:对145例绝经后出血的患者进行宫腔镜检查,对可疑病灶针对性地进行诊刮,组织物行病理检查。结果:绝经后子宫出血的原因以子宫腔内良性占位病变居首位(子宫内膜息肉54例、宫颈管息肉13例、子宫粘膜下肌瘤29例)共96例,占66.21%;其次为非器质性病变(萎缩性子宫内膜9例、子宫内膜炎25例及增生期子宫内膜2例)共36例,占24.83%;子宫内膜癌导致的出血10例占6.90%。年龄超过60岁及绝经年限超过10年的子宫内膜癌的发生率明显上升。绝经后良性宫腔占位87例采用宫腔镜手术治疗。结论:良性病变是绝经后出血的主要原因,宫腔镜在诊断绝经后出血方面具有较高的准确性,是目前治疗绝经后宫腔良性占位所致绝经后出血的最佳方法。

Clinical application Value of hysteroscopy in diagnosis and treatment of patients with postmenopausal bleeding

Objective:To discuss the clinical application value of hysteroscopy in diagnosis and treatment of patients with postmenopausal bleeding.Methods:145 patients were examined by hysteroscopy,uterine curettage was used for questionable lesions and pathological examination was carried out.Results:The most common effect factor of postmenopausal bleeding was intrauterine benign space occupying lesions,which accounted for 66.21%(96 patients,including 54 patients of endometrial polyps,13 patients of cervical polyps and 29 patients of submucous myoma);the second was non-organic pathologic changes,which accounted for 24.83%(36 patients,including 9 patients of atrophic endometrium,25 patients of endometritis and 2 patients of proliferative phase of endometrium);the third was endometrial carcinoma,which accounted for 6.90%(10 patients).The incidence of endometrial carcinoma was high in patients who were older than 60 or menopausal duration was over than 10 years.87 patients with benign space occupying lesions were treated by hysteroscopy operation.Conclusion:Intrauterine benign space occupying lesions are majoy effcet factors of postmenopausal bleeding,hysteroscopy is the best therapeutic measure.