宫腔镜技术在异常子宫出血患者诊疗中的应用价值  

Diagnostic and therapy effect of hysyeroscopic technology in abnormal uterine bleeding

作　　者：王莹[1] 徐彩临[1] 曹艳花[1] 陈颖[1] 

机构地区：[1]厦门市第三医院妇产科,福建厦门361100

出　　处：《海南医学院学报》2015年第3期415-417,420,共4页Journal of Hainan Medical University

摘　　要：目的：探讨异常子宫出血的常见原因和宫腔镜在异常子宫出血患者中的应用价值。方法：选取2012年1月-2012年12月期间因异常子宫出血在我院住院行宫腔镜手术的患者94例为研究对象,分析其宫腔镜检查、术前超声情况、术后病理以及宫腔镜治疗术后的效果。结果：94例异常子宫出血的病例,其中功能失调性子宫出血21例（22.34%）,子宫内膜息肉29例（30.85%）,子宫肌瘤27例（28.72%）,宫颈管息肉10例（10.64%）,宫内异物5例（5.32%）,子宫内膜瘤样病变1例,子宫内膜癌1例。术前60例超声检查宫内异常回声,宫腔镜术后证实有器质性病变和异物的53例;术前34例超声检查宫内无异常回声,宫腔镜术后证实有器质性病变和异物的20例。异常子宫出血病因宫腔镜诊断阳性率77.66%,高于超声诊断（63.82%）（χ^2=4.34,P〈0.05）。子宫肌瘤患者行宫腔镜电切后,异常子宫出血的症状全部改善,子宫内膜息肉和宫颈管息肉的患者行息肉电切术后,少部分患者症状改善不理想,需结合激素药物治疗。结论：功能失调性子宫出血、子宫内膜息肉、子宫肌瘤是异常子宫出血的常见原因,宫腔镜检查能明确其原因,宫腔镜电切术治疗子宫肌瘤效果好,治疗子宫内膜息肉后辅助药物治疗能达到满意的治疗效果,所以,宫腔镜技术应成为异常子宫出血的首选检查治疗方法。Objective： To explore the common causes of abnormal uterine bleeding and the value of hysteroscopic application in patients with abnormal uterine bleeding. Methods： A total of 94 abnormal uterine bleeding cases with hysteroscopic surgery admitted from January 2012 to December 2012 in our hospital were selected. Result of the hysteroscopy, preoperative ultrasound scanning, pathological examination and the efficacy of postoperative endoscopic treatment were observed and com- pared. Results： There were 21 cases with dysfunctional uterine bleeding （accounting for 22.34%）, 29 cases of endometrial pol yp （30.85%）, 27 cases of uterine fibroids （28.72 %）, 10 eases with cervical polyp （10.64%）, 5 cases of intrauterine foreign body （5.32%）, 1 case of endometrial neoplasia, and 1 case of endometrial cancer. There were 60 cases of intrauterine abnor- malities echo ultrasound, 53 cases with organic disease and foreign materials confirmed by hysteroscopy surgery, 34 cases without abnormal echo, 20 cases of organic disease and foreign materials confirmed by hysteroscopic surgery. The positive diagnostic rate of hysteroscopy was 77.66%, significant higher that of ultrasound diagnosis （63.82%） （χ^2 =4.34, P〈0.05）. After resection under hysteroscopy abnormal uterine bleeding symptoms of patients with uterine fibroids were all improved. And after resection of polyps improvement in some patients with cervical polyps was not satisfactory, and hormone therapy was needed. Conclusions： Dysfunctional uterine bleeding, endometrial polyps, uterine fibroids are common cause for abnormal uterine bleeding. Hysteroscopy is helpful to find out the cause. Resection of uterine fibroids under hysteroscopy is of good effect,and is the preferred examination method and treatment of abnormal uterine bleeding.

关 键 词：宫腔镜 异常子宫出血 超声 

分 类 号：R711.74[医药卫生—妇产科学]