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目的探讨宫腔镜检查在异常子宫出血病因诊断中的应用价值。方法 2008年9月至2010年10月,对486例异常子宫出血患者进行宫腔镜检查,同时行镜下活检及组织学检查。结果 (1)子宫内膜癌、萎缩性子宫内膜的发病年龄较大,正常子宫内膜及子宫内膜息肉、子宫内膜增生则多见于30~50岁异常子宫出血患者。(2)宫腔镜与病理诊断符合率:正常子宫内膜83.1%,子宫内膜息肉89.0%,子宫黏膜下肌瘤97.3%,子宫内膜炎95.0%,子宫内膜增生93.2%,萎缩性子宫内膜96.9%,子宫内膜癌75.0%。宫腔镜检查与病理组织学诊断总体符合率达90.1%。结论宫腔镜检查是诊断异常子宫出血原因的较好手段,镜下定位活检病理检查能提高诊断准确性。
Objective To investigate the value of hysteroscopy in the etiological diagnosis of abnormal uterine bleeding. Methods From September 2008 to October 2010, 486 patients with abnormal uterine bleeding were examined by hysteroscopy and underwent microscopic biopsy and histological examination. Results (1) The age of onset of endometrial cancer and atrophic endometrium is larger. The normal endometrium and endometrial polyps and endometrial hyperplasia are more common in patients with abnormal uterine bleeding of 30-50 years old. (2) Hysteroscopy and pathological diagnosis coincidence rate: 83.1% of normal endometrium, 89.0% of endometrial polyps, 97.3% of uterine fibroids, 95.0% of endometritis, 93.2% of endometrial hyperplasia, atrophic 96.9% endometrium, endometrial cancer 75.0%. Hysteroscopy and pathological diagnosis of the overall compliance rate of 90.1%. Conclusion Hysteroscopy is a better way to diagnose the cause of abnormal uterine bleeding. Microscopic localization biopsy can improve diagnostic accuracy.