不孕症患者子宫内膜吸管活检和诊断性刮宫的比较研究  

COMPARISON BETWEEN ENDOMETRIAL PIPELLE DEVICE VERSUS DILATION AND CURETTAGE FOR ENDOMETRIAL BIOPSY IN INFERTILITY WOMEN

作　　者：郑峥[1] 王宁宁[2] 姜向坤[1] 张玉凤 王瑞东[2] 柯佩琪[2] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院妇科,深圳518028 [2]中山大学附属第一医院妇科 [3]广东佛山南海里水医院妇产科

出　　处：《现代预防医学》2010年第14期2647-2649,2651,共4页Modern Preventive Medicine

基　　金：广东省自然科学基金资助项目(8151008901000124;04009377);广东省科技计划资助项目(2007B080701011;2006B50107001;2005B34201020);广东省医学科研基金资助项目(A2009672)

摘　　要：[目的]比较子宫内膜吸管活检和诊刮在不孕症患者中病理诊断差异。[方法]选择2008年1月～2009年12月在深圳市妇幼保健院妇科就诊的63例和中山大学附属第一医院就诊5例不孕患者为研究对象,选取月经来潮或撤退性出血d20～25,同一患者先用子宫内膜吸管进行子宫内膜活检,作为子宫内膜活检组(A组);然后诊刮,作为诊刮组(B组);先后对两组标本进行评估和病理检查。[结果]A组和B组被评为标本质量"不满意"比例分别为7.4%(5/68)和2.9%(2/68),两组比较差异无统计学意义(P=0.25)。取评价标本满意的63对标本进行配对比较,正常周期子宫内膜的检出率分别为45/63和41/63,两组比较差异无统计学意义(P=1.0);内膜息肉检出率分别为7/63和12/63,两组比较无统计学差异(P=0.774);子宫内膜炎的检出率分别为3/63和3/63,两组比较差异无统计学意义(P=1.0);子宫内膜增殖症的检出率分别为7/63和6/63,两组比较差异无统计学意义(P=1.0);子宫内膜癌的检出率分别为1/63和1/63,两组比较无统计学差异(P=1.0)。63名患者术后分别对疼痛进行评分,A组为(1.8±0.26),B组为(4.7±0.42),两组比较差异有统计学意义(t=-33.79,P=0.00)。[结论]对于不孕症患者,子宫内膜吸管活检与诊刮的子宫内膜组织病理诊断基本一致。[Objective] To compare the specimen quality and the pathologic diagnosis accuracy between endometrial Pipelle device versus dilation and curettage（DC） in infertility women.[Methods] 63 outpatients of infertility were selected from Shenzhen Maternity and Child healthcare Hospital and 5 outpatients of infertility were selected from the first Affiliated Hospital of Sun Yat-sen University for the DC treatment at 20-25 th day from onset of menstrual cycle.An endometrial biopsy were collected by endometrial Pipelle device（Group A）,and DC（Group B） were performed for the same patient.The pathologic diagnosis and the specimen quality were evaluated.The pain score were recorded by verbal rating scales-5.The assessment and pathological detection were performed in the two groups.[Results] The rate of specimen with unsatisfactory quality were 7.4%（5/68） in Group A（2/68） and 2.9% for Group B（P = 0.25）,and there was no significant difference in the two groups.63 pairs of specimen with satisfactory quality were compared.No significant difference was shown between two groups on normal menstrual phase endometrium（45/63versus 41/63）,endometrial polypus（7/63 versus 12/63）,endometritis（3/63 versus 3/63）,endometrial hyperplasia（7/63 versus 6/63） and endometrial carcinoma（1/63 versus 1/63）.63 pairs of patients have the pain score 1.8＋0.26 in Group A and 4.7＋0.42 in Group B.There were statistical difference between two groups（t =-33.79,P = 0.00）.[Conclusion] Endometrial Pipelle device could keep with DC to evaluate endometrial pathological diagnosis in infertility patients.

关 键 词：子宫内膜活检 诊断性刮宫 不孕症 

分 类 号：R711.6[医药卫生—妇产科学]