Zlatkov V, Kostova P, Barzakov G, Tcholakova A, Milochov V, Velinov E, Radeva V, Mihova A
Clinic of Gynecology, National Transport Hospital King Boris III, Sofia, Bulgaria.
J BUON. 2007 Jan-Mar;12(1):53-6.
The objective of our study was to analyze the possibilities of diagnostic flexible hysteroscopy in women with irregular uterine bleeding.
The study involved 661 women aged 26-72 years (mean 46.23) with mild to moderate irregular uterine bleeding who agreed to have invasive investigations. Diagnostic hysteroscopy by panoramic fibrohysteroscope Pentax LH-150 II (5 mm in diameter) was performed initially to all patients, followed by classical dilatation and curettage (D & C).
Different types of normal endometrium were found in 248 (37.52%) women, hyperplasia and polyposis in 300 (45.39%), suspected changes for atypia and neoplasia in 82 (12.40%) and other different findings in 31 (4.69%). Subsequent D & C showed lack of adequate material from the uterine cavity in 26 (3.93%) women, in 538 (81.39%) the morphological findings were due to hormonal and dyshormonal reasons, 66 (9.98%) were with different precancer and cancer lesions and in 31 (4.69%) cases, clinically and morphologically, bleeding was due to the presence of submucosal myomas, intrauterine devices, residua and pathology of the chorion.
The comparison of the hysteroscopy results with clinical and histological findings from D & C showed good diagnostic possibilities of the flexible hysteroscopy for evaluation of women with irregular bleeding (sensitivity 74.07% and specificity 90.61%). This examination is relatively simple, safe and requires simultaneous performance of a direct biopsy, in order to improve the accuracy of the results.
我们研究的目的是分析诊断性柔性宫腔镜检查在子宫不规则出血女性中的应用可能性。
该研究纳入了661名年龄在26至72岁（平均46.23岁）、有轻度至中度子宫不规则出血且同意进行侵入性检查的女性。首先对所有患者进行Pentax LH - 150 II型全景纤维宫腔镜（直径5毫米）诊断性宫腔镜检查，随后进行经典的刮宫术（D&C）。
248名（37.52%）女性发现不同类型的正常子宫内膜，300名（45.39%）有增生和息肉样变，82名（12.40%）有疑似非典型和肿瘤性改变，31名（4.69%）有其他不同发现。随后的刮宫术显示，26名（3.93%）女性宫腔取材不足，538名（81.39%）的形态学发现是由激素及激素失调原因导致的，66名（9.98%）有不同的癌前病变和癌症病变，31名（4.69%）病例在临床和形态学上，出血是由黏膜下肌瘤、宫内节育器、残留物及绒毛膜病变引起的。
宫腔镜检查结果与刮宫术的临床及组织学结果比较显示，柔性宫腔镜检查在评估子宫不规则出血女性方面具有良好的诊断可能性（敏感性74.07%，特异性90.61%）。这项检查相对简单、安全，且需要同时进行直接活检，以提高结果的准确性。
