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异常子宫出血患者宫腔镜检查结果及组织学诊断的患病率

Prevalence of hysteroscopic findings and histologic diagnoses in patients with abnormal uterine bleeding.

作者信息

Lasmar Ricardo Bassil, Dias Rogério, Barrozo Paulo Roberto Mussel, Oliveira Marco Aurélio Pinho, Coutinho Evandro da Silva Freire, da Rosa Daniela Baltar

机构信息

Department of Gynecology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.

出版信息

Fertil Steril. 2008 Jun;89(6):1803-7. doi: 10.1016/j.fertnstert.2007.05.045. Epub 2007 Sep 24.

Abstract

OBJECTIVE

To describe the prevalence of hysteroscopic findings and histologic diagnoses in patients with abnormal uterine bleeding (AUB).

DESIGN

Retrospective series of consecutive patients.

SETTING

Tertiary care university hospital and private office.

PATIENT(S): Four thousand fifty-four hysteroscopies with biopsy in patients with AUB evaluated between June 1993 and December 2004.

INTERVENTION(S): Hysteroscopies were performed using 2.9-mm or 4-mm telescopes with CO(2) or saline as the distension media. Biopsies were done with a 5-mm grasper or with a Novak's curette.

MAIN OUTCOME MEASURE(S): Prevalence of hysteroscopic findings and histologic analysis of biopsies.

RESULT(S): Endometrial polyp was the most frequent hysteroscopic finding, accounting for 1,374 (33.9%) cases. Normal uterine cavity and cervical canal were found in 814 (20.1%) patients. Submucous fibroids were diagnosed in 302 (7.5%) women. Normal endometrium was the most frequent histologic diagnosis, accounting for 1,888 (46.6%) cases. Endometrial polyp was found in 1,115 (27.5%) patients. Endometrial hyperplasia was diagnosed in 613 (15.1%) and endometrial cancer in 105 (2.6%) women.

CONCLUSION(S): Endometrial polyps are the most frequent hysteroscopic findings in patients with AUB, whereas normal endometrium is the most frequent histologic diagnosis.

摘要

目的

描述异常子宫出血(AUB)患者宫腔镜检查结果及组织学诊断的患病率。

设计

对连续患者进行的回顾性系列研究。

地点

三级医疗大学医院及私人诊所。

患者

1993年6月至2004年12月期间对4054例AUB患者进行了宫腔镜检查及活检。

干预措施

使用2.9毫米或4毫米的宫腔镜,以二氧化碳或生理盐水作为膨宫介质进行宫腔镜检查。活检采用5毫米抓钳或诺瓦克刮匙。

主要观察指标

宫腔镜检查结果的患病率及活检的组织学分析。

结果

子宫内膜息肉是最常见的宫腔镜检查发现,占1374例(33.9%)。814例(20.1%)患者子宫腔和宫颈管正常。302例(7.5%)女性诊断为黏膜下肌瘤。正常子宫内膜是最常见的组织学诊断,占1888例(46.6%)。1115例(27.5%)患者发现子宫内膜息肉。613例(15.1%)诊断为子宫内膜增生,105例(2.6%)女性诊断为子宫内膜癌。

结论

子宫内膜息肉是AUB患者最常见的宫腔镜检查发现,而正常子宫内膜是最常见的组织学诊断。

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