绝经后子宫出血宫腔镜下的诊断和治疗

为评价宫腔镜对绝经后子宫出血的诊断和治疗价值，对我院１９９０年７月－１９９４年７月收治的１３５例绝经后子中出血病例进行宫腔检查，部分行镜下手术治疗。结果：萎缩性子宫内膜６２例、子宫内膜息肉２５例、宫颈息肉１３例、子宫内膜癌１３例、子宫内膜增殖症１１例、粘膜下肌瘤５例、宫内节育器６例。和病理诊断的符合率分别为１００％、９６％、１００％、６９％、７３％及８０％。１３５例中６例曾作诊断性刮宫检查无异常者

Diagnosis and Treatment of Postmenopausal Uterine Bleeding hy Hysteroscopy

bjectives To evaluate the value of hysteroscopy in diagnosis and treatment of patients with post-menopausal uterine bleeding.Methods One hundred and thirty-five patients with postmenopausal bleeding hospitalized in ourdepartment from July 1990 to July 1994 were examined by hysteroscopy. The results of 124 cases werecompared with pathological findings obtained during uterine curettage. Thirty-nine patients were operat-ed simultaneously under hysteroscopy.Results Under hysteroscopy, atrophic endometrium, endometrial polyps, cervical polyps, en-dometrial carcinoma, endometrial hyperplasia, submucous myoma were diagnosed in 62 cases (45.9% ),25 cases (18.5% ), 13 cases (9.6% ), 13 cases (9.6% ), 11 cases (8.2% ) and 5 cases (3.7%) respec-tively. The remaining 6 ( 4.5% ) had IUD insertion. These findings were confirmed pathologically in115 out of l24 cases (92.7% ). There were 9 cases misdiagnosed by hysteroscopy. 6 cases had false neg-ative results during previous curettage. Twenty-two cases of endometrial polyps,13 cases of cervicalpolyps and 4 cases of pediculated submucous myoma were removed hysteroscopically without any compli-cation.Conclusions Hysteroscopy is an effective method for identifying the causes of postmenopausaluterine bleeding, which is superior to curettage of uterus. For some selected patients hysteroscopic oper-ations can be performed at the same time.