宫腔镜诊断与治疗绝经后子宫出血90例临床分析

目的:探讨宫腔镜对绝经后异常子宫出血的诊断及治疗价值。方法:对90例绝经后出血的患者进行宫腔镜检查,分析导致绝经后出血的宫腔内因素。对镜下诊断为子宫粘膜下肌瘤、子宫内膜息肉、子宫颈肌瘤及息肉的47例行宫腔镜手术治疗,9例子宫内膜癌患者接受开腹手术,并最终获得组织病理诊断。随诊观察手术疗效。结果:绝经后异常子宫出血的原因以子宫腔内良性占位病变居首位(子宫内膜息肉27例,子宫粘膜下肌瘤7例,宫颈管息肉13例)共47例,其次是萎缩性子宫内膜炎共31例,子宫内膜癌为第3位共9例。绝经后良性宫腔占位47例均采用宫腔镜手术治疗,手术时间短,创伤小,术后恢复快,无一例手术并发症。结论:宫腔镜检查直观准确,是绝经后异常子宫出血病因检查的首选方法;宫腔镜手术创伤小、疗效高,是目前治疗绝经后宫腔良性占位所致异常子宫出血的最佳方法。

Value of hysteroscopy on diagnosis and treatment of post menopausal uterine bleeding

Objective:To evaluate hysteroscopy in diagnosis and treatment of postmenopausal bleeding.Methods:90 cases of postmenopausal bleeding were examined used hysteroscopy.47 patients who suffered myoma or polypus were underwent electroresection through hysteroscopic operation,another 9 patients received trans-abdominal hysterectomy as endometrial carcinoma.Results:Etiology to causing postmenopausal uterine bleeding included endometrial polypus,submucosa myoma,cervix polypus,endometritis,and endometrial carcinoma.The benign lesion in uterine cavity could be treated efficiency by hysteroscopic operation.Conclusion:Hysteroscopic examination is the best way for diagnosis of postmenopausal uterine bleeding,and hysteroscopic operation is the best way for treatment the benign lesion in uterine cavity.