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目的 :探讨B超、宫腔镜和分段诊刮术在绝经后阴道流血病因诊断中的应用价值。方法 :采集绝经后阴道流血 2 0 4例 ,分析其病因诊断中B超、宫腔镜和分段诊刮术的配合使用情况。结果及结论 :良性疾病 177例 (占 86 8%) ,恶性疾病 2 7例 (占13 2 %)。良性疾病中以生殖器炎症最多 ,86例 (占 42 2 %)。恶性疾病中以子宫内膜癌最多 ,15例 ,占恶性肿瘤的 5 5 6%。宫腔镜配合子宫内膜诊刮能提高子宫内膜息肉、内膜癌和肌瘤的检出率 ,尤其适用于持续性出血的患者。B超初筛可使部分患者避免不必要的诊刮。 6例宫颈癌和 2例CIN均累犯宫颈管 ,因此对疑为宫颈癌者行宫颈活检前应强调作颈管刮术
Objective: To investigate the value of B-ultrasound, hysteroscopy and segmental curettage in the diagnosis of post-menopausal vaginal bleeding. Methods: 204 cases of postmenopausal vaginal bleeding were collected, and the combined use of ultrasound, hysteroscopy and segmental curettage in the diagnosis of the disease was analyzed. RESULTS AND CONCLUSION: 177 cases (86.8%) of benign diseases and 27 cases (132%) of malignant diseases were found. Genital inflammation in benign diseases up to 86 cases (42 2%). Endometrial cancer in malignant disease up to 15 cases, accounting for 55.6% of malignant tumors. Hysteroscopy with endometrial curettage can improve the detection of endometrial polyps, endometrial cancer and fibroids, especially for patients with persistent bleeding. B-primary screening can make some patients avoid unnecessary curettage. 6 cases of cervical cancer and 2 cases of CIN are recidivist cervical canal, cervical suspected cervical cancer biopsy should be emphasized before cervical scraping