宫腔镜、B超检查对异常子宫出血的诊断价值

目的探讨宫腔镜、B超在诊断异常子宫出血中的应用价值。方法回顾分析2001年4月至2004．年9月初诊为异常子宫出血并进行了B超、电子官腔镜检查的86例病例。结果B超报告子宫内膜正常者42例，宫腔镜诊断宫内膜息肉2例、增殖期子宫内膜4例、宫颈管小息肉2例，病理报告与宫腔镜诊断相符。B超发现异常情况44例，经宫腔镜检查活检、诊刮的病理报告异常的有32例，宫腔镜对诊断宫内膜息肉、子宫肌瘤、宫内膜癌的准确性较高分别达100％、83．33％、100％，宫腔镜诊断宫内膜增生、宫内膜萎缩的准确性分别达61．9％、50％。宫腔镜诊断子宫异常出血的漏诊率为0，腹部结合阴道B超检查的敏感性为90．6％，漏诊率9．3％。结论宫腔镜检查只有结合B超并与定位组织活检、诊刮相结合，才能提高对宫腔内疾病诊断的准确性。

The value of hysteroscopy and B ultrasonic in diagnosing of abnormal uterine bleeding

Objective To evaluate hysteroscopy and B ultrasonic in the diagnosis of abnormal uterine bleeding(AUB).Methods Retrospective analyze 86 patients that preliminary diagnosesed of AUB from 2001.4. to 2004.9.Results 42 cases were reported by B ultrasonic as normal endometrium.As to hysteroscopy,2 cases were diagnosesed endometrial polyp,4 cases of endometrial hyperplasia,2 cases of little cervical ployp.Pathological report were match to the hysteroscopy diagnoses.Among 44 cases that diagnoseced abnormal by B ultrasonic,32 cases were reported abnormal by pathological report by hysteroscopy and localizational endometrial biopsy or endometrial curettage.AS to the diagnoses of endometrial polyp,hysteromyoma and endometrial carcinoma,the hysteroscopy had an accuracy of 100%,83.33% and 100% respectively.As to the diagnoses of endometrial hyperplasia and atrophic endometrium,the hysteroscopy had an accuracy of 61.9% and 50%.AS to the diagnosis of AUB,the rate of missed diagnosis is 0 with hysteroscopy,B ultrasonic of abdominal combined with vagina had a sensitivity of 90.6%,and had a rate of missed diagnosis of 9.3%.Conclusion The hysteroscopy must combined with B ultrasonic,tissue pathological examination of localizational endometrial biopsy or endometrial curettage to improve the accuracy of diagnosis of endometrial disease.