测定E_2在宫腔镜治疗绝经后子宫内膜息肉的重要意义

目的：探讨雌二醇（E2）测定在宫腔镜治疗绝经后子宫内膜息肉（EP）的指导意义。方法：分析2006年—2008年住院的24例以绝经后出血为主诉,宫腔镜检查确诊为子宫内膜息肉的患者。术前常规测定雌激素水平和子宫内膜病理检查。行宫腔镜下息肉电切手术,2例子宫内膜息肉患者子宫内膜增生过长,行宫腔镜子宫内膜息肉切除术（transcervical resection of polyp,TCRP）同时子宫内膜切除术（transcervical resection of endometrium,TCRE）,其余病例使用电切镜一次或分次自根蒂部全部切除病灶,即TCRP。结果：术后门诊复查。2例EP子宫内膜增生过长伴E2升高,行TCRP同时TCRE术,术后12个月无异常。而22例行TCRP患者中,2例在术后3个月,3例在术后6个月~12个月发生反复出血,保守治疗失败,改为子宫全切术,术后病理排除恶性病变。这5例患者术前均有E2升高,4例为增生期子宫内膜,1例萎缩型子宫内膜。结论：绝经后阴道出血与雌激素水平增高密切相关,绝经后子宫内膜息肉患者45.8%有E2水平升高,这些患者出血病灶不局限于息肉,因此,伴有E2升高的患者宜行TCRE同时TCRP。

Significance of Determination of E2 Level in the Uteroscopic Treatment of Endometrial Polyps in Postmenopausal Women

Objective：To deal with clinical significance of E2 detection on Uteroscopic Treatment of Endometrial Polyps in Postmenopausal women.Methods：24 patients who had postmenopausal uterus bleed associated with endometrial polyps identified by uteroscopy between Jan.2006 and May 2008 in our hospital,and who had undergone the transcervical resection of polyp（TCRP） or transcervical resection of endometrium（TCRE）,were assessed retrospectively.Moreover,the E2 level was determined conventionally as well as endometrium pathology before the uteroscopic surgery.Results：2 of 24 cases were conducted TCRP and TCRE because excessive proliferation of endometrium,and they were normal after 12 months of followed up.5 of 22 cases of underwent TCRP were performed hysterectomy due to occur uterus bleed after 3-12 months of uteroscopic surgery,and increased E2 level.Conclusions：The results suggest that treatment of patients with uterus endometrial Polyps associated with higher E2 in Postmenopause should be performed with TCRE and TCRP.