中国医药导报
中國醫藥導報
중국의약도보
China Medical Herald
2015年
30期
102-105
,共4页
厉霞玲%刘德佩%张月存%冷丽丽
厲霞玲%劉德珮%張月存%冷麗麗
려하령%류덕패%장월존%랭려려
宫腔镜%异常子宫出血%病理检查%诊治%宫腔镜下电切术
宮腔鏡%異常子宮齣血%病理檢查%診治%宮腔鏡下電切術
궁강경%이상자궁출혈%병리검사%진치%궁강경하전절술
Hysteroscopy%Abnormal uterine bleeding%Pathological examination%Diagnosis and treatment%Hystero-scopic polypectomy
目的：探讨宫腔镜在异常子宫出血诊治中的临床价值。方法回顾分析2014年1~11月南京中医药大学附属南京市中西医结合医院异常子宫出血患者65例的临床资料，所有患者均通过宫腔镜检查、病灶摘除、病理检查进行诊断和治疗。分析宫腔镜检查在异常子宫出血诊治中的临床应用。结果宫腔镜检查发现子宫内膜不同程度增生20例，内膜息肉13例、内膜炎16例，内膜增生或分泌期改变9例，肌瘤4例，妊娠物残留3例。所有患者检查后行定位活检、内膜诊刮、病灶摘除(大的息肉和黏膜下肌瘤采用宫腔镜下电切术)。病理结果示院内膜增殖症27例、内膜息肉10例，内膜炎9例、内膜增生或分泌期改变14例，黏膜下肌瘤2例，妊娠物残留3例。总的宫腔镜和病理检查符合率为78.46%。术后失访10例，随访率为84.62%；随访的55例中复发5例，复发率为9.09%；50例治愈，治愈率为90.90%。结论宫腔镜检查协助病理检查，直视宫内病变，可以明确异常子宫出血者病因并进行相应治疗，达到全面、精细、准确的目的，值得临床推广。
目的：探討宮腔鏡在異常子宮齣血診治中的臨床價值。方法迴顧分析2014年1~11月南京中醫藥大學附屬南京市中西醫結閤醫院異常子宮齣血患者65例的臨床資料，所有患者均通過宮腔鏡檢查、病竈摘除、病理檢查進行診斷和治療。分析宮腔鏡檢查在異常子宮齣血診治中的臨床應用。結果宮腔鏡檢查髮現子宮內膜不同程度增生20例，內膜息肉13例、內膜炎16例，內膜增生或分泌期改變9例，肌瘤4例，妊娠物殘留3例。所有患者檢查後行定位活檢、內膜診颳、病竈摘除(大的息肉和黏膜下肌瘤採用宮腔鏡下電切術)。病理結果示院內膜增殖癥27例、內膜息肉10例，內膜炎9例、內膜增生或分泌期改變14例，黏膜下肌瘤2例，妊娠物殘留3例。總的宮腔鏡和病理檢查符閤率為78.46%。術後失訪10例，隨訪率為84.62%；隨訪的55例中複髮5例，複髮率為9.09%；50例治愈，治愈率為90.90%。結論宮腔鏡檢查協助病理檢查，直視宮內病變，可以明確異常子宮齣血者病因併進行相應治療，達到全麵、精細、準確的目的，值得臨床推廣。
목적：탐토궁강경재이상자궁출혈진치중적림상개치。방법회고분석2014년1~11월남경중의약대학부속남경시중서의결합의원이상자궁출혈환자65례적림상자료，소유환자균통과궁강경검사、병조적제、병리검사진행진단화치료。분석궁강경검사재이상자궁출혈진치중적림상응용。결과궁강경검사발현자궁내막불동정도증생20례，내막식육13례、내막염16례，내막증생혹분비기개변9례，기류4례，임신물잔류3례。소유환자검사후행정위활검、내막진괄、병조적제(대적식육화점막하기류채용궁강경하전절술)。병리결과시원내막증식증27례、내막식육10례，내막염9례、내막증생혹분비기개변14례，점막하기류2례，임신물잔류3례。총적궁강경화병리검사부합솔위78.46%。술후실방10례，수방솔위84.62%；수방적55례중복발5례，복발솔위9.09%；50례치유，치유솔위90.90%。결론궁강경검사협조병리검사，직시궁내병변，가이명학이상자궁출혈자병인병진행상응치료，체도전면、정세、준학적목적，치득림상추엄。
Objective To explore the clinical value of hysteroscopy in the diagnosis and treatment of patients with ab-normal uterine bleeding. Methods Clinic date of 65 cases of abnormal uterine bleeding admitted in Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Nanjing University of Chinese Medicine from January to November 2014 were retrospectively analyzed. The patients were checked by hysteroscopy, lesion removal, biopsy for diagnosis and treatment. Through the comparative analysis of the above methods, the clinical application of hysteroscopy in the diagnosis and treatment of abnormal uterine bleeding was analyzed. Results Hysteroscopy found that various degree of endometrial hyperplasia in 20 cases,13 cases of endometrial polyps, 16 cases of endometritis, 9 cases of endometrial hyperplasia or secretory phase change, 4 cases of uterine fibroids, 3 cases of pregnancy residues. After hysteroscopy, all patients were given biopsy,curettage, lesion removal (large polyps and submucosal fibroids were givn hysteroscopic polypectomy). Pathology showed that 27 cases of various degree of endometrial hyperplasia, 10 cases of endometrial polyps, 9 cases of endometritis, 4 cases of endometrial hyperplasia or secretory phase change, submucous myoma of uterus 2 cases, 3 cases of pregnancy residues. The coincidence rate of diagnosis between pathology and pathological examination was 78.46%. Postoperative follow-up, 5 cases of recurence, recurence rate was 9.09%; 50 cases of cure, the cure rate was 93.85%. Conclusion Hysteroscopy can directly observe the intrauterine pathologies, and to assist pathological examination in the diagnosis and treatment of abnormal uterine bleeding, achieve the goal of comprehen-sive, detailed and accurate, is worthy of clinical promotion.
