宫腔镜诊治围绝经期子宫出血(附138例报告)

目的 :探讨宫腔镜在诊治围绝经期异常子宫出血 (perimenopausaluterinebleeding ,PMUB)的价值。方法 :回顾分析PMUB 138例用宫腔镜诊治的临床资料。结果 :138例中子宫内膜息肉 5 5例 ,子宫颈息肉 2 9例 ,粘膜下子宫肌瘤 4 0例 ,子宫内膜增生过长 6例 ,子宫内膜不典型增生 3例 ,子宫内膜癌 1例 ,正常子宫内膜 4例。总体检查阳性率为 97 10 %。术中 1例发生子宫穿孔并发症。术后随访 2 ～12个月 ,随访率为82 6 1% ,患者症状明显改善 10 6例 ,满意率为 92 98%。结论 :用宫腔镜诊断PMUB有相当高的特异性和准确性。可同时治疗良性病变 ,减少不必要的开腹手术 ,是治疗PMUB的首选方法。

The diagnosis and treatment of the perimenopausal uterine bleeding with hysteroscopy:with a report of 138 cases

Objective:To evaluate the value of hysteroscopy in diagnosis and treatment of the perimenopausal uterine bleeding.Methods:The clinical data of 138 cases of PMUB diagnosed and treated by hysteroscopy was reviewed retrospectively.Results:The results of pathology were as follows:endometrial polyp 39.86%(55/138),cervical polyp 21.01%(29/138),submucous fibromyoma 28.99%(40/138),endometrial hyperplasia 4.35%(6/138),atypical hyperplasia 2.17%(3/138),endomerial adenocarcinoma 0.72%(1/138),normal endometrium 2.90%(4/138). The rate of sensitivity was 97.10%. One case occurred the complication of rupture of uterine. 114 cases were followed up for 2-12 months after the operation. 106 of them were satisfied with the therapy. The satisfied rates were 92.98%.Conclusions:There is higher sensitivity and speciality in dignosis of PMUB with hysteroscopy. Hysteroscopic surgery is therapeutic in the benign lesion,reduces the needs of unnecessary laparotomy,and is an optimal method for the PMUB.