论文部分内容阅读
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。
Objective: To investigate the diagnostic value of TV fiber hysteroscopy (hysteroscopy) and diagnostic curettage (DCH) in the diagnosis of abnormal uterine bleeding (AUB) both alone and in combination. Methods: 460 cases of AUB patients were examined by hysteroscopy and curettage. The types of endometrial lesions in different endometrial lesions were analyzed and compared. The changes of endometrial lesions in different age groups were analyzed. The two methods were simple and combined examination The results were compared with postoperative pathological findings. Results: (1) In 89 cases of AUB, 75 cases had uterine lesions, 70 cases (93.33%) were diagnosed by hysteroscopy and 21 cases (28.00%) diagnosed by curettage. (2) The age of onset of endometrial cancer, atrophic endometrium and endometritis in 398 cases of endometrial lesions was significantly higher than that of normal endometrium, endometrial polyps, hyperplasia of endometrium, Hyperplasia, adenoma hyperplasia and dysplasia. (3) Endometrial lesions in different age groups, the first cause of menopausal bleeding is atrophic endometrial, followed by endometritis; childbearing age AUB is the first one due to endometrial polyps, followed by For the normal endometrium; menopausal patients with endometrial adenoid cystic hyperplasia more common. (4) The hysteroscopy sensitivity (93.33%), accuracy (92.13%) was significantly higher than the curettage examination (sensitivity 28.00%, accuracy 30.20%). Conclusions: Simple hysteroscopy is suitable for the diagnosis of intrauterine lesions in AUB. Simple diagnosis by curettage may provide a basis for histopathological diagnosis, but it is easy to miss intrauterine organic mass lesions. Hysteroscopic positioning curettage examination can improve the sensitivity and accuracy of diagnosis for the diagnosis of AUB etiology of a reliable method.