电视纤维宫腔镜检查对异常子宫出血的诊断价值
异常子宫出血,,异常子宫出血；,宫腔镜检查；,诊断性刮宫检查中图分类号R616.2;,R711.52,文献标识码A,文章编号10095551(2006)05038104,电视纤维宫腔镜检查
摘要：目的：探讨电视纤维宫腔镜(简称宫腔镜)检查、诊断性刮宫(简称诊刮)检查单独及联合应用对异常子宫出血(AUB)的诊断价值。方法：对460例AUB患者进行宫腔镜和诊刮检查，分析并比较不同子宫内膜病变类型患者的年龄及不同年龄时期子宫内膜病变的类型变化，并对2种检查方法单纯和联合检查的结果与手术后病理结果进行比较。结果：(1)89例手术治疗AUB患者中75例有子宫病变，宫腔镜检查确诊70例(93.33%)，诊刮检查确诊21例(28.00%)。(2)398例子宫内膜病变患者中子宫内膜癌、萎缩性子宫内膜、子宫内膜炎的发病年龄明显大于正常子宫内膜、子宫内膜息肉、内膜增生过长、腺囊型增生、腺瘤型增生和不典型增生。(3)在不同年龄时期子宫内膜病变中，绝经期出血的第1位原因是萎缩性子宫内膜，其次为子宫内膜炎；育龄期AUB的第1位原因是子宫内膜息肉，其次为正常子宫内膜；更年期患者以子宫内膜腺囊型增生过长多见。(4)宫腔镜检查的灵敏度(93.33%)、准确度(92.13%)明显高于诊刮检查(灵敏度28.00%、准确度30.20%)。结论：单纯宫腔镜检查适用于诊断AUB有宫内病变者，单纯诊刮检查可提供组织病理学诊断依据，但易遗漏宫内器质性占位病变。宫腔镜下定位诊刮检查可提高诊断的灵敏度及准确性，为诊断AUB病因的可靠方法。关键词：异常子宫出血； 宫腔镜检查； 诊断性刮宫检查中图分类号：R616.2; R711.52 文献标识码：A 文章编号：10095551(2006)05038104
The diagnostic value of televisual fibrohysteroscopy in patients
with abnormal uterine bleeding
DING Yan, YAO Liyan, Zulfiya Ali, et al
(Department of Gynecology and Obstetrics, First Affiliated Hospital,
Xinjiang Medical University, Urumqi 830000, China)
Abstract: Objective: To investigate the diagnostic value of hysteroscopy, uterine curettage alone and combined hysteroscopy with uterine curettage and offer a raliable diagnostic method. Methods: Four hundred and sixty patients were diagnosed by hysteroscopy and uterine curettage. To analysis and compare the different age of patients of uterine endometrium lesions and the variance of different period of uterine endometrium lesion, the results of preoperative hysteroscopy, uterine curettage and hysteroscopy combined with uterine curettage were compared with the postoperative pathologic findings. Results： (1) In 89 patients hospitalized for surgical treatment, 75 patients had uterine lesions, 70 patients were diagnosed by hysteroscopy(93.33%), 21 patients were diagnosed by uterine curettage(28.00%). (2) In 398 patients of uterine endometrium lesions, the patients′age of onset of carcinoma of endometrium, atrophic endometrium, endometritis are higher than normal uterine endomerium, endometrial polyps, hyperplasia of endometrium, simple hyperplasic, complex hyperplasic and atypical hyperplasic. (3) Pathological changes in the different age period uterine endometrium lesions, carcimoma of endometrium was the first reason of menopause uterine bleeding, followed by atrophic uterine endometrium and uterine endometritis. While endometrial polyps was the first reason of reproductive period uterine bleeding, followed by normal uterine endometrium and hyperplasic of endometrium. In perimenopause patients, the simple hyperplasic of endometrium patients were particularly prevalent. (4)The sensitivity (93.33%) and accuracy (92.13%) of hysteroscopy were evidently higher than uterine curettage (the sensitivity was 28%, the accuracy was 30.20%). Conclusions: Hysteroscopy is very advantageous to diagnosis of abnormal uterine bleeding with intrauterine lesions. Uterine curettage may offer histopathologic diagnosis, but it is easy to omit the intrauterine lesions. The present study has shown that hysteroscopy combined with uterine curettage could increase the diagnostic effectiveness and accuracy in patients with abnormal uterine bleeding. It is the most useful examinatorial method. ......
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