宫腔镜定位刮宫术对围绝经期异常子宫出血的诊断价值  

Diagnostic value of hysteroscopic curettage in patients with peri-menopausal abnormal uterine bleeding

作　　者：花茂方[1] 姚军 蒋巧玲 HUA Maofang;YAO Jun;JIANG Qiaoling(Department of Gynaecology,Lianyungang Maternity and Child Health Care Hospital,Lianyungang 222006,China)

机构地区：[1]江苏省连云港市妇幼保健院妇科,江苏连云港222006

出　　处：《现代医学》2020年第4期481-484,共4页Modern Medical Journal

摘　　要：目的:对比分析宫腔镜定位刮宫术和常规诊断性刮宫两种手术方式对围绝经期异常子宫出血(AUB)的诊断价值。方法:回顾分析2016年1月至2018年6月期间我院门诊及住院患者中围绝经期AUB患者,共1443例。其中门诊常规诊断性刮宫术组(A组)1116例,住院行宫腔镜检查定位刮宫术组(B组)327例,对比分析两组取得的子宫内膜病理结果。结果:两组刮宫病理诊断在单纯子宫内膜增生、子宫内膜息肉、子宫内膜不典型增生、子宫内膜癌4项病理诊断上差异有统计学意义(P<0.05),子宫内膜息肉、子宫内膜不典型增生、子宫内膜癌的诊断率B组高于A组。单纯性子宫内膜增生检出率A组高于B组,差异具有统计学意义(P<0.05)。而在慢性子宫内膜炎、蜕膜样组织等原因引起的AUB中,两种方法差异无统计学意义。结论:围绝经期AUB病因复杂,宫腔镜检查定位诊刮术结合病理检查能够早期发现子宫内膜恶性肿瘤,早期治疗,使患者获益最大化。Objective:To compare the diagnostic value of hysteroscopic curettage and the routine diagnostic curettage in patients with peri-menopausal abnormal uterine bleeding(AUB).Methods:1443 cases of outpatients and hospitalized patients with AUB in our hospital were retrospectively analyzed between Jan.2016 and Jun.2018.1116 cases of patients in the outpatient department received routine diagnostic curettage(group A),and 327 cases of patients in hospital underwent hysteroscopic and diagnostic curettage(group B).The pathological types of endometrium in two groups were analyzed.Results:The diagnostic rate of hysteroscopic curettage was higher than that in the examination of the routine diagnostic curettage in the diagnosis of endometrial polyps,atypical hyperplasia of endometrium and endometrial cancer,and the difference was statistically significant(P<0.05).The diagnostic rate of the routine diagnostic curettage is higher than that in the hysteroscopic curettage in diagnosis of endometrial simple hyperplasia,and the difference was statistically significant(P<0.05).There was insignificance between the two methods in the diagnosis of chronic endometritis,deciduoid tissue and so on.Conclusion:Peri-menopausal AUB has a complex etiology,which can comprehensively evaluate by hysteroscopic curettage.Combined with pathologi-cal examination,it can detect endometrial malignant tumors early,and early treatment can maximize the benefit of patients with AUB.

关 键 词：围绝经期 异常子宫出血 病理类型 宫腔镜定位刮宫术 常规诊断性刮宫 

分 类 号：R711[医药卫生—妇产科学]