Liu Y, Zhou Y, Wen H
First Teaching Hospital, Beijing Medical University.
Zhonghua Fu Chan Ke Za Zhi. 1995 Dec;30(12):732-4.
To evaluate the value of hysteroscopy in diagnosis and treatment of patients with postmenopausal uterine bleeding.
One hundred and thirty-five patients with postmenopausal bleeding hospitalized in our department from July 1990 to July 1994 were examined by hysteroscopy. The results of 124 cases were compared with pathological findings obtained during uterine curettage. Thirty-nine patients were operated simultaneously under hysteroscopy.
Under hysteroscopy, atrophic endometrium, endometrial polyps, cervical polyps, endometrial carcinoma, endometrial hyperplasia, submucous myoma were diagnosed in 62 cases (45.9%), 25 cases (18.5%), 13 cases (9.6%), 13 cases (9.6%), 11 cases (8.2%) and 5 cases (3.7%) respectively. The remaining 6 (4.5%) had IUD insertion. These findings were confirmed pathologically in 115 out of 124 cases (92.7%). There were 9 cases misdiagnosed by hysteroscopy. 6 cases had false negative results during previous curettage. Twenty-two cases of endometrial polyps, 13 cases of cervical polyps and 4 cases of pediculated submucous myoma were removed hysteroscopically without any complication.
Hysteroscopy is an effective method for identifying the causes of postmenopausal uterine bleeding, which is superior to curettage of uterus. For some selected patients hysteroscopic operations can be performed at the same time.
评估宫腔镜检查在绝经后子宫出血患者诊断和治疗中的价值。
对1990年7月至1994年7月在我科住院的135例绝经后出血患者进行宫腔镜检查。将124例患者的检查结果与刮宫时获得的病理结果进行比较。39例患者在宫腔镜检查的同时进行了手术。
宫腔镜检查发现，萎缩性子宫内膜、子宫内膜息肉、宫颈息肉、子宫内膜癌、子宫内膜增生、黏膜下肌瘤分别有62例（45.9%）、25例（18.5%）、13例（9.6%）、13例（9.6%）、11例（8.2%）和5例（3.7%）。其余6例（4.5%）为宫内节育器置入。124例中有115例（92.7%）经病理证实。宫腔镜检查误诊9例。刮宫时6例有假阴性结果。宫腔镜下切除22例子宫内膜息肉、13例宫颈息肉和4例带蒂黏膜下肌瘤，无任何并发症。
宫腔镜检查是明确绝经后子宫出血病因的有效方法，优于子宫刮宫术。对于部分选定患者可同时进行宫腔镜手术。
