March C M
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles 90033.
J Reprod Med. 1992 Apr;37(4):293-311; discussion 311-2.
Hysteroscopy is a "new" endoscopic approach for the gynecologist. The development and refinement of the sophisticated fiberoptic light system can illuminate the darkness of the uterine cavity. Polyps can be differentiated from submucous myomas; intrauterine adhesions can be accurately "mapped" and classified, with synechiae lysed under direct vision; endometrial carcinoma can be diagnosed and possibly staged; embedded intrauterine devices can be identified and dislodged; the wastebasket diagnosis of "dysfunctional uterine bleeding" can be cleaned up; submucosal myomas and uterine septa can be resected; and successful transuterine sterilization may become a reality. If culdoscopy is menopausal and laparoscopy in its reproductive years, hysteroscopy is certainly in its infancy.
宫腔镜检查对妇科医生来说是一种“新的”内窥镜检查方法。精密的光纤照明系统的发展和完善能够照亮子宫腔的黑暗。息肉可与黏膜下肌瘤相鉴别;宫腔粘连能够被精确地“描绘”和分类,在直视下分离粘连;子宫内膜癌能够被诊断,甚至可能进行分期;嵌顿的宫内节育器能够被识别并取出;“功能失调性子宫出血”这种笼统的诊断可以得到明确;黏膜下肌瘤和子宫纵隔能够被切除;成功的经子宫绝育术可能会成为现实。如果说盆腔镜检查处于更年期,腹腔镜检查处于生育期,那么宫腔镜检查肯定尚处于起步阶段。