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1、电视纤维宫腔镜检杳对异常子宫出血的诊断价值【关键词】异常子宫出血摘要：目的：探讨电视纤维宫腔镜(简称宫腔镜)检杳、诊断性刮宫(简称诊刮)检杏小独及联合应用対异常子宫出血(AUB)的诊断价值。方法：对460例AUB患者进行宫腔镜和诊刮检查，分析并比较不同子宫内膜病变类型患者的年龄及不同年龄吋期子宫内膜病变的类型变化，并对2种检査方法单纯和联合检查的结杲与手术后病理结果进行比较。结杲：(1)89例手术治疗AUB患者中75例有子宫病变，宫腔镜检查确诊70例(93.33%),诊刮检查确诊21例(2&00%)。(2)398
2、例子宫内膜病变患者中子宫内膜癌、萎缩性子宫内膜、子宫内膜炎的发病年龄明显大于止常子宫内膜、子宫内膜息肉、内膜増牛过长、腺囊型增牛、腺瘤型增生和不典型增生。(3)在不同年龄时期子宫内脱病变中，绝经期出血的第1位原因是萎缩性子宫内膜，其次为子宫内膜炎；育龄期AUB的第1位原因是子宫内膜息肉，其次为止常子宫内膜；更年期患者以子宫内膜腺囊型增生过长多见。(4)宫腔镜检查的灵敏度(93.33%)、准确度(92.13%)明显高于诊刮检查(灵敏度28.00%、准确度30.20%)。结论单纯宫腔镜检查适用于诊断AUB有宫内病变者
3、，单纯诊刮检杏可提供组织病理学诊断依据，但易遗漏宫内器质性占位病变。宫腔镜下定位诊刮检查可提高诊断的灵敏度及准确性，为诊断AUB病因的可靠方法。关键词：异常子宫出血；宫腔镜检查；诊断性刮宫检查中图分类号：R616.2;R711.52文献标识码：A文章编号：10095551(2006)05038104ThediagnosticvalueoftelevisualfibrohysteroscopyinpatientswithabnormaluterinebleedingDINGYan,YAOLiyan,ZulfiyaA
4、li,etal(DepartmentofGynecologyandObstetrics,FirstAffiliatedHospital,XinjiangMedicalUniversity,Urumqi830000,China)Abstract:Objective:Toinvestigatethediagnosticvalueofhysteroscopy,uterinecurettagealoneandcombinedhysteroscopywithuterinecurettageandofferaraliable
5、diagnosticmethod・Methods:Fourhundredandsixtypatientswerediagnosedbyhysteroscopyanduterinecurettage.Toanalysisandcomparethedifferentageofpatientsofuterineendometriumlesionsandthevarianceofdifferentperiodofuterineendometriumlesion,theresultsofpreoperativehyster
6、oscopy,uterinecurettageandhysteroscopycombinedwithuterinecurettagewerecomparedwiththepostoperativepathologicfindings・Results：(1)In89patientshospitalizedforsurgicaltreatment,75patientshaduterinelesions,70patientswerediagnosedbyhysteroscopy(93.33%),21patientswe
7、rediagnosedbyuterinecurettage(28.00%).(2)In398patientsofuterineendometriumlesions,thepatients'ageofonsetofcarcinomaofendometrium,atrophicendometrium,endometritisarehigherthannormaluterineendomerium,endometrialpolyps,hyperplasiaofendometrium,simplehyperplasic,
8、complexhyperplasicandatypicalhyperplasic・(3)Pathologicalchangesinthedifferentageperioduterineendometriumlesions,carcimomaofendometriumwasthefirstreasonofmenopauseuterinebleeding,followedb
