宫腔镜下异常子宫出血的诊治分析

目的研究宫腔镜在检查异常子宫出血中的效果,分析其诊断价值。方法将2012年1月～2013年12月深圳市宝安区计划生育专科医院收治的200例异常子宫出血患者随机分为实验组和对照组,每组各100例,实验组应用宫腔镜检查结合诊断性刮宫术及病理活检,对照组运用传统的阴道B超结合诊断性刮宫术。对检测出异常的患者实施相应适合的宫腔镜手术。统计并比较两组的检出率和治愈率。结果实验组的检出异常率为98%,子宫内膜活检,2例表现为轻度增生,宫腔镜检查没有发现异常。经宫腔镜手术后,患者均被治愈。对照组检出异常率为75%,经宫腔镜手术后,治愈率为76%,未被治愈及未被检出的再行宫腔镜检及活检内镜检查,检出异常者39例,漏诊率为39%,4例子宫内膜病理检查表现为轻度增生,宫腔镜检查没有发现异常。实验组子宫内膜增生、子宫内膜息肉、妊娠残留及合计诊断符合率均高于对照组,差异均有统计学意义（P〈0.05或P〈0.01）。结论异常子宫出血的宫腔镜检查及手术治疗具有很高的价值,是安全和有效的。

Diagnosis and treatment of abnormal uterine bleeding hysteroscopic

Objective To research the clinical efficacy of hysteroscopy in abnormal uterine bleeding inspection, and analyze its diagnostic value. Methods 200 patients with abnormal uterine bleeding from January 2012 to December 2013in Family Planning Specialized Hospital of Bao＇an District in Shenzhen City were divided into experimental group and control group randomly, with 100 cases in each group. The experimental group was treated by combining diagnostic hysteroscopy and curettage biopsy, the control group was treated by combination of traditional vaginal B-diagnostic curettage. Appropriate hysteroscopic surgery was implemented in patients with an abnormality. The rates of detection and cure between two groups were statistical calculated and compared. Results Aspects of the experimental group, the detection of abnormal was 98%, 2 cases of endometrial biopsy showed mild hyperplasia, hysteroscopy found no abnormalities. After hysteroscopy, patients were cured. Aspects of the control group, the detection of abnormal was 75%, after hysteroscopy, the cure rate was 76%, those patients who were not be cured and detected were given the diagnostic hysteroscopy and curettage biopsy again, 39 cases ware anomaly detection, the misdiagnosis rate was 39%, 4 cases of endometrial biopsy showed mild hyperplasia, hysteroscopy found no abnormalities. The diagnose accordance rate of hyperplasia endometrii, endometrial polyp, pregnancy residues in the experimental group were higher than those of the control group, the differences were statistically significant（P〈0.05 or P〈0.01）. Conclusion Hysteroscopy and surgical treatment of abnormal uterine bleeding had higher value, which safety and effective.