宫腔镜检查生育期妇女异常子宫出血316例分析

目的探讨宫腔镜检查生育期异常子宫出血的诊断价值。方法对316例22～49岁异常子宫出血、经妇科检查、经腹B超及经阴道B超,提示宫腔回声异常或正常者进行宫腔镜检查,检查时间选择在月经周期的增殖早期,月经周期紊乱者在阴道流血停止或明显减少时。结果 宫腔镜检查生育期妇女异常子宫出血,子宫腔内病变阳性检出率为83.50％。宫腔镜检查与病理结果符合率平均为71.14％,其中子宫内膜单发或多发性息肉>1.20cm及子宫粘膜下肌瘤>0.50cm诊断准确,术后病理诊断符合率为80。01％～95.02％。子宫内膜息肉样增生,病理诊断为子宫内膜息肉者仅为22.01％,宫腔镜检查呈息肉样增生时必须取内膜活检,依据病理作出临床诊断。结论宫腔镜检查适用于生育期异常子宫出血,并可明确出血的病因。对子宫内膜炎性病变及宫内节育器并发症,宫腔镜可观察到节育器在子宫腔内的形态、位置及宫内膜反应。另宫腔镜下选择性内膜定位活检或全面刮宫取材送病理,二者结合可得出正确的临床诊断。

Analysis of 316 abnormal endometrial bleeding of women in sexual maturity examined by hysteroscopy

Objective To study the applicability of hysteroscopy for abnormal endometrial bleeding of women In sexual maturity. Methods 316 cases of fertility women with abnormal endometrial bleeding were examined by hysteroscopy, whose situations were showed first under bimanual or trimanual examinations, then trans abdominal or trans vaginal B - ultrasonograpy. The time of examination started in the early hyperplasia period or the stop or reduce of the abnormal bleeding. Results The positive rate of uterine abnormality was 83.5 % and the coincidence rate of hysteroscopy and pathology was 71.14%. For the size of single or multiple endometrial polyps > 1.20 cm, for suhmucosal endometrial myoma was > 0.50 cm, the coincidence rate of pathological diagnosis was 80.01% - 95.02% after the operation. 83.50% with abnormal endometrial bleeding could be diagnosed with hysteroscopy directly. Conclusion Hysteroscopic examination was useful for abnormality endometrial bleeding of women in sexual maturity, from which the biopsy of local lesion could be directed or whole uterine curettage could be done.