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目的 探讨B超诊断为宫腔内占位的妇科疾病类型和宫腔镜治疗的效果。 方法 回顾分析我院 2 0 0 0年 8月～ 2 0 0 1年 7月宫腔内占位 78例 ,在宫腔镜下检查和治疗后取下病变 ,并送病理。 结果 78例中有症状者 6 2例 (79 5 % )。其中异常阴道出血者 5 8例 (74 4 % ) ,腹痛或异常阴道排液 4例 (5 1% ) ;其余 16例 (2 0 5 % )无症状查体发现。术中无 1例出现明显并发症。术后病理结果 :子宫内膜息肉 4 0例 ,单纯性增生 16例 ,复合性增生 1例 ,子宫内膜或腺体非典增生 3例 ,子宫内膜癌 1例 ,子宫肌瘤或腺肌瘤 11例 ,不全流产 1例 ,正常子宫内膜 5例 ,分别占 5 1 3% ,2 0 5 % ,1 3% ,3 9% ,1 3% ,14 1% ,1 2 8% ,6 4 1%。绝经期宫腔内的异常占位 ,85 7% (30 / 35例 )都是良性病变。术后随访 2～ 12个月 ,随访率 88 5 % (6 9/ 78) ,总满意率为 94 2 % (6 5 / 6 9)。绝经的 35例中 4例失访 ,31例全部满意手术结果。 结论 B超诊断为宫腔内占位的患者 ,以良性病变为主 ,绝经期的宫腔内异常占位 ,更适于宫腔镜手术。
Objective To investigate the type of gynecological diseases diagnosed by intrauterine ultrasound and the effect of hysteroscopy treatment. Methods A retrospective analysis of 78 cases of intrauterine occupancy in our hospital from August 2000 to July 2001, after hysteroscopic examination and treatment, remove the lesion and send pathology. Results Among the 78 cases, 62 were symptomatic (79.5%). There were 58 cases (74.4%) with abnormal vaginal bleeding, 4 cases (5.1%) with abdominal pain or abnormal vaginal discharge, and the remaining 16 cases (20%) were found asymptomatic examination. No significant intraoperative complications occurred. Pathological results: 40 cases of endometrial polyps, simple hyperplasia in 16 cases, 1 case of complex hyperplasia, endometrial or glandular atypical hyperplasia in 3 cases, 1 case of endometrial cancer, uterine fibroids or adenomyosis 11 cases, 1 case of incomplete abortion and 5 cases of normal endometrium, accounting for 51.3%, 20.5%, 13.3%, 39%, 13%, 14.1%, 128%, 64 1%. Abnormal menstrual uterine cavity, 857% (30/35 cases) are benign lesions. The patients were followed up for 2 to 12 months. The follow-up rate was 88.5% (69/78). The overall satisfaction rate was 94.2% (65/69). Of the 35 cases of menopause, 4 were lost to follow-up, and 31 were satisfied with the results of surgery. Conclusion B-ultrasound diagnosis of intrauterine space occupying patients, with benign lesions, intrauterine abnormal menstruation occupies more suitable for hysteroscopic surgery.