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目的：根据绝经后子宫出血患者子宫内膜的阴道超声检查形态设计评分方法，以利于临床筛选诊断性刮宫（诊刮）病例。方法：对１８２例绝经后子宫出血患者行阴道超声检查并进行评分，其中１３５例施行诊刮术，将每例的超声评分与诊刮的组织病理检查（病检）结果相比较。结果：患者评分高低与内膜的病检结果明显相关。评分＜３的７２例中仅１例（１．４％）为子宫内膜癌，而评分≥３的６３例中３２例（５０．８％）为子宫内膜癌。评分越高，内膜癌的真阳性率越高。结论：阴道超声检查可作为绝经后子宫出血患者筛选诊刮的手段，根据子宫内膜形态评分高低决定是否行诊刮有临床参考价值，但需进一步结合行腹部超声或（及）宫腔超声检查验证，即便是良性子宫内膜，亦需结合患者的临床具体情况决定是否行诊刮术。
OBJECTIVE: To design a scoring method based on vaginal ultrasound examination of endometrium in postmenopausal women with uterine bleeding to facilitate the clinical screening of cases of diagnostic curettage. Methods: 182 cases of postmenopausal uterine bleeding patients underwent vaginal ultrasound examination and score, including 135 cases of curettage surgery, the ultrasound score of each case and curettage histopathological examination (disease test) results were compared. Results: There was a significant correlation between the score of patients and the results of pathological examination of intima. Only 1 of 72 cases (<1.4%) with score <3 had endometrial cancer, while 32 (50.8%) of 63 cases with score> 3 had endometrial cancer. The higher the score, the higher the true positive rate of endometrial cancer. Conclusion: Vaginal ultrasonography can be used as a screening tool in patients with postmenopausal uterine bleeding. According to the score of endometrial morphology, it is of clinical significance to decide whether to cure a curettage. However, ultrasound combined with abdominal ultrasound (or ultrasonography) Verify that even benign endometrial, patients need to be combined with the specific circumstances of the decision whether to curettage.