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目的探讨宫腔镜检查诊断子宫内膜良恶性病变的临床价值。方法回顾性分析245例因超声检查提示宫腔异常行宫腔镜检查及病理诊断患者的临床资料,总结其临床及病理特点。结果 245例患者中,子宫内膜息肉177例(72.2%),子宫内膜增生23例(9.4%),黏膜下子宫肌瘤20例(8.2%),子宫内膜炎9例(3.7%),子宫内膜不典型增生12例(4.9%),子宫内膜癌4例(1.6%)。宫腔镜下诊断的子宫内膜息肉的术后病理符合率为90.4%,子宫内膜增生的术后病理符合率为65.2%,黏膜下子宫肌瘤的术后病理符合率为95.0%,子宫内膜炎的术后病理符合率为66.7%,不典型增生及子宫内膜癌的术后病理符合率为68.8%。102例有症状患者子宫内膜不典型增生及子宫内膜癌的检出率(10.8%)高于无症状患者(3.5%),差异有统计学意义(P<0.05)。结论对于超声提示宫腔异常的患者,宫腔镜检查是一种安全、有效的检查方式。宫腔占位中最常见的病理类型是子宫内膜息肉,无症状但持续内膜增厚的患者,行宫腔镜检查可早期发现子宫内膜恶性病变。
Objective To investigate the clinical value of hysteroscopy in the diagnosis of benign and malignant endometrial lesions. Methods Retrospective analysis of 245 cases of hysteroscopy and pathological diagnosis of abnormal uterine cavity hysteroscopy prompted clinical data to summarize the clinical and pathological features. Results Of the 245 patients, 177 (72.2%) had endometrial polyps, 23 (9.4%) had endometrial hyperplasia, 20 (8.2%) had submucosal uterine fibroids and 9 (3.7%) had endometritis , Endometrial dysplasia in 12 cases (4.9%), endometrial carcinoma in 4 cases (1.6%). Hysteroscopic diagnosis of endometrial polyps postoperative pathology coincidence rate was 90.4%, endometrial hyperplasia postoperative pathological coincidence rate was 65.2%, submucosal uterine fibroids postoperative pathology coincidence rate was 95.0%, the uterus The postoperative pathological coincidence rate of endometritis was 66.7%, and the postoperative pathological coincidence rate of atypical hyperplasia and endometrial carcinoma was 68.8%. 102 cases of symptomatic patients with endometrial dysplasia and endometrial cancer detection rate (10.8%) was higher than asymptomatic patients (3.5%), the difference was statistically significant (P <0.05). Conclusion Hysteroscopy is a safe and effective way to diagnose abnormal uterine cavity in patients with ultrasound. Uterine cavity occupying the most common pathological type of endometrial polyps, asymptomatic but persistent intimal thickening of patients, hysteroscopy can be early detection of endometrial malignant lesions.