宫腔镜手术联合诊断在中老年子宫内膜癌患者中的临床对比研究  

The clinical comparasive study on hysteroscopic surgery combined diagnosis in middle-aged and elderly patients with endometrial cancer

作　　者：陈瑞芝[1] CHEN Ruizhi(Department of Gynecology,Laizhou People's Hospital in Shandong Province,Laizhou 261400,China)

机构地区：[1]山东省莱州市人民医院妇科,山东莱州261400

出　　处：《中国现代医生》2018年第7期60-63,共4页China Modern Doctor

摘　　要：目的探讨宫腔镜手术联合诊断在中老年子宫内膜癌患者诊断中的应用价值。方法选取我院妇产科2010年1月～2017年1月期间诊治的子宫内膜癌患者共185例,根据诊断方法分为观察组(宫腔镜组)和对照组(分段诊刮组),比较两组病例一般情况、子宫内膜活检病理与术后病理符合率及术前联合评估分期与手术病理分期结果比较的准确率。结果观察组97例,对照组88例。两组病例年龄段构成、BMI、手术病理分期和术后病理类型构成比差异无统计学意义(P>0.05);观察组术前诊断与术后病理符合94例(96.9%)(其余2例漏诊,1例病理类型不符),高于对照组的78例(88.6%)(其余7例漏诊,3例病理类型不符)(P<0.05);观察组术前联合诊断分期准确率为Ia期88.6%、Ib期93.8%与对照组Ia期71.7%、Ib期71.4%比较差异有统计学意义(P<0.05);观察组Ⅱ期72.7%、III&IV期70.0%与对照组Ⅱ期80.0%、Ⅲ&IV期者93.8%比较差异无统计学意义(P>0.05)。结论对中老年子宫内膜癌患者应用宫腔镜手术联合诊断,与常规分段诊刮方法相比,提高了诊断效能,有利于综合评估病情,具有重要临床价值。Objective To evaluate the value of hysteroscopic surgery in the diagnosis of middle-aged and elderly patients with endometrial cancer.Methods A total of 185 cases of endometrial cancer diagnosed and treated in the Department of Obstetrics and Gynecology of our hospital from January 2010 to January 2017 were selected and divided into observation group(hysteroscopy group)and control group(fractional curettage group).The general situation of two groups of patients,the coincidence rate between endometrial biopsy pathology and postoperative pathology and the accuracy of preoperative joint assessment staging and surgical pathology staging results were analyzed and compared.Results There were 97 cases in the observation group and 88 cases in the control group.There was no significant difference in the composition of age,BMI,pathological stage of the operation and postoperative pathological type between the two groups(P>0.05).There were 94 cases of coincidence of the preoperative diagnosis and postoperative pathology of the observation group(96.9%)(the other 2 cases with misdiagnosis,and 1 case not matching pathological type),higher than 78 cases(88.6%)in the control group(the other 7 cases with misdiagnosis,and 3 cases not matching pathological type)(P<0.05).The staging accuracy rate of preoperative combined diagnosis in the observation group was 88.6%in stage Ia and 93.8%in stage Ib.And the staging accuracy rate in the control group was 71.7%in stage Ia and 71.4%in stage Ib.There was significant difference between the two groups(P<0.05).While there were no statistically significant difference between the 72.7%in stageⅡ,70.0%in stage III&IV of observation group and 80.0%in stageⅡ,93.8%of stageⅢ&Ⅳof the control group(P>0.05).Conclusion The application of hysteroscopy combined diagnosis in middle-aged and elderly patients with endometrial cancer improves the diagnostic efficacy,compared with conventional fractional curettage,and is conducive to a comprehensive assessment of the disease,which has important clinical

关 键 词：宫腔镜手术 子宫内膜癌 联合诊断 分期 

分 类 号：R737.3[医药卫生—肿瘤]