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目的研究子宫内膜细胞学检查在绝经后女性宫腔积液诊断中的应用价值。方法阴道超声筛查出宫腔积液的绝经后女性,对能接受子宫内膜细胞学检查的患者取子宫内膜细胞,将其结果与子宫内膜活体组织检查(活检)的病理结果进行对比。结果 1子宫腔内膜细胞学检查标本取材满意率91.07%(102/112);分段诊断性刮宫(诊刮)病理学检查者标本取材满意率86.61%(97/112)。2在筛查出的112例患者中,共有94例患者既有子宫内膜细胞学检查结果又有组织病理学结果。子宫内膜细胞学检查(子宫腔刷)未见上皮内病变和恶性细胞87例(92.55%),良性增生性改变1例(1.06%),子宫内膜细胞不典型增生2例(2.13%),子宫内膜腺癌4例(4.26%)。病理检查结果仅为单纯子宫腔积液、宫腔积脓,未见异常的患者57例(60.64%);子宫内膜良性病变(子宫黏膜下肌瘤、子宫内膜息肉、子宫内膜增生、子宫内膜炎)30例(31.91%);子宫内膜不典型增生2例(2.13%);子宫内膜腺癌5例(5.32%)。结论绝经后妇女经阴道超声发现宫腔积液,应密切监测子宫内膜。对药物、手术的耐受性低、治疗风险大的老年女性,子宫内膜细胞学检查是一种较好的筛查子宫内膜病变和引流子宫腔积液的方法。尤其是难以刮出足量内膜组织进行病理学诊断时,子宫内膜细胞学检查可用于术前筛查子宫内膜病变,具有一定的临床价值。
Objective To study the value of endometrial cytology in diagnosis of uterine fluid in postmenopausal women. Methods Vaginal ultrasound screening of postmenopausal women with uterine effusion, endometrial cytology can take patients with endometrial cells, the results and endometrial biopsy (biopsy) pathological results were compared . Results 1 The rate of endometrial cytology was 91.07% (102/112). The satisfactory rate was 86.61% (97/112) in the sectional diagnostic curettage specimens. 2 Of 112 patients screened, 94 patients had both endometrial cytology and histopathological findings. Endometrial cytology (intrauterine brush) showed no intraepithelial lesions and malignant cells in 87 cases (92.55%), benign hyperplasia in 1 case (1.06%), endometrial cell dysplasia in 2 cases (2.13%), , 4 cases of endometrial adenocarcinoma (4.26%). Pathological examination results were only simple uterine effusion, uterine empyema, no abnormalities in 57 patients (60.64%); benign endometrial lesions (uterine fibroids, endometrial polyps, endometrial hyperplasia, 30 cases (31.91%) of endometritis, 2 cases of endometrial dysplasia (2.13%) and 5 cases (5.32%) of endometrial adenocarcinoma. Conclusions Transvaginal sonography of uterine effusion was found in postmenopausal women. The endometrium should be closely monitored. Endometrial cytology is a good method of screening for endometrial lesions and drainage of uterine fluid in elderly women with low drug and surgical tolerance and high risk of treatment. In particular, it is difficult to scrape out adequate endometrial tissue for pathological diagnosis, endometrial cytology can be used for preoperative screening of endometrial lesions, has some clinical value.