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目的:探讨宫腔镜检查在临床诊断中的价值。方法:收集青海红十字医院2014年1月—2014年12月行宫腔镜检查患者1 500例的临床资料,对其进行分析,其中因异常子宫出血,影像学及妇科检查未见明显异常者行宫腔镜检查的378例,因子宫肌瘤行宫腔镜检查757例,因影像学考虑子宫内膜息肉行宫腔镜检查78例,宫内节育器异位及宫内异物的定位行宫腔镜检查38例,因不孕症行宫腔镜检查169例,因影像学提示纵隔子宫、双子宫,行宫腔镜检查共19例,因妇科检查发现宫颈息肉行宫腔镜检查的48例,因闭经或月经量过少,行宫腔镜检查共13例。结果:黏膜下肌瘤237例,功能失调性子宫出血278例,子宫内膜息肉173例,节育器嵌顿17例,节育器异位9例,节育器残留2例,稽留流产5例,胎盘胎膜残留3例,胎骨残留1例,宫腔粘连13例,双子宫2例,完全纵膈3例,不全性纵膈14例;宫颈息肉36例;宫腔积脓4例,子宫颈癌6例,子宫内膜癌19例。结论:宫腔镜检查可明确诊断引起异常子宫出血的病因,明确宫内异物的位置及形态;有助于及早发现由宫腔病变、子宫病变及子宫畸形导致的不孕,且宫腔镜检查安全可靠,可直视宫腔内情况,可指导妇科疾病的治疗及手术方式的选择,具有其他检查无法替代的优点。
Objective: To explore the value of hysteroscopy in clinical diagnosis. Methods: The clinical data of 1 500 cases of hysteroscopy in Qinghai Red Cross Hospital from January 2014 to December 2014 were collected and analyzed. Among them, abnormal uterine bleeding, imaging and gynecological examination showed no abnormalities 378 cases of endoscopy, uterine fibroids due to hysteroscopy in 757 cases, endometrial polyps due to imaging hysteroscopy in 78 cases, intrauterine device ectopic and intrauterine foreign body positioning hysteroscopy 38 Cases, hysteroscopy due to infertility in 169 cases, due to imaging prompted hysteroscopic uterus, double uterus, hysteroscopy, a total of 19 cases, due to gynecological examination of cervical polyps hysteroscopy in 48 cases, due to menopause or menstrual flow Too few, hysteroscopy a total of 13 cases. Results: 237 cases of submucous myoma, dysfunctional uterine bleeding in 278 cases, 173 cases of endometrial polyps, IUD incarceration in 17 cases, 9 cases of heterotopic IUD, 2 cases of residual IUD, missed abortion in 5 cases, placenta 3 cases of residual fetal membrane, 1 case of residual fetal bone, 13 cases of intrauterine adhesions, 2 cases of double uterus, 3 cases of complete mediastinum, 14 cases of incomplete mediastinum, 36 cases of polyp of cervix, 4 cases of uterine empyema, 6 cases of cancer, 19 cases of endometrial cancer. Conclusion: Hysteroscopy can clearly diagnose the etiology of abnormal uterine bleeding, clarify the location and morphology of intrauterine foreign body, help to find the infertility caused by uterine lesions, uterine lesions and uterine malformations earlier, and hysteroscopy Safe and reliable, can be directly under the condition of the uterine cavity, can guide the treatment of gynecological diseases and the choice of surgical approach, with other checks can not be replaced by the advantages.