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目的分析绝经后子宫出血(postmenopausal uterus bleeding,PMB)的病因,探讨宫腔镜检查对绝经后子宫出血的诊断效果。方法 2010年1月～2011年6月在我院妇科门诊就诊的绝经后阴道出血的患者96例,行宫腔镜检查术,检查后常规刮宫或直视下定位取材送病理检查,分析宫腔镜检查与病理检查结果。结果绝经后子宫出血的病因,依次为子宫内膜炎、子宫内膜息肉、子宫内膜增生、黏膜下肌瘤及子宫内膜癌。宫腔镜诊断子宫内膜良性病变阳性预测值为96.55%(84/87),子宫恶性肿瘤阳性预测值为83.33%(5/6)。宫腔镜检查结果与病理诊断符合率高达90.04%。结论宫腔镜检查术是诊断绝经后子宫出血原因的最有效的方法,结合病理检查可提高诊断的准确性。
Objective To analyze the etiology of postmenopausal uterus bleeding (PMB) and to evaluate the diagnostic value of hysteroscopy in the diagnosis of postmenopausal uterine bleeding. Methods From January 2010 to June 2011, 96 cases of postmenopausal vaginal bleeding in gynecology outpatient department of our hospital were treated by hysteroscopy. The patients underwent routine curettage or direct vision were taken for pathological examination, and hysteroscopy Check with the results of pathological examination. Results The causes of postmenopausal uterine bleeding were endometritis, endometrial polyps, endometrial hyperplasia, submucosal fibroids and endometrial cancer. The positive predictive value of hysteroscopy in the diagnosis of endometrial benign lesions was 96.55% (84/87), and the positive predictive value of uterine malignant tumors was 83.33% (5/6). The coincidence rate of hysteroscopy and pathological diagnosis was as high as 90.04%. Conclusion Hysteroscopy is the most effective method to diagnose the causes of postmenopausal uterine bleeding, and combined with pathological examination can improve the diagnostic accuracy.