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目的:探讨宫腔镜联合超声检查对绝经后妇女宫腔内病变的诊断价值。方法:应用宫腔镜联合超声检查对149例绝经后妇女宫腔内病变进行检查,术前均行超声,术中定位取材或诊断性刮宫术。结果:在149例病例中,宫腔镜联合超声检查诊断黏膜下肌瘤20例,与病理诊断符合率100.0%;子宫内膜息肉49例,与病理诊断符合率100.0%;萎缩性内膜炎31例,与病理诊断符合率81.6%;子宫内膜增生13例,与病理诊断符合率61.9%;子宫内膜癌13例,与病理诊断符合率92.9%。结论:对绝经后子宫内膜病变的病因诊断中,宫腔镜联合超声检查提高了子宫内膜息肉及黏膜下肌瘤的诊断率。对子宫内膜增生症和子宫内膜癌的诊断,因可以镜下定位诊刮,亦提高了诊断率。宫腔镜联合超声检查对宫内病变的诊断率及治疗具有重要的诊断价值,值得推广应用。
Objective: To investigate the value of hysteroscopy combined with ultrasonography in the diagnosis of intrauterine lesions in postmenopausal women. Methods: Hysteroscopy combined with ultrasound examination of 149 cases of postmenopausal women with intrauterine lesions were examined before surgery, ultrasound, intraoperative mapping or diagnostic curettage. Results: Among 149 cases, 20 cases of submucosal fibroids were diagnosed by hysteroscopy combined with ultrasonography. The coincidence rate was 100.0% with pathological diagnosis, and 49 cases with endometrial polyps. The coincidence rate was 100.0% with pathological diagnosis. Atrophic endometritis 31 cases, consistent with the pathological diagnosis of 81.6%; endometrial hyperplasia in 13 cases, consistent with the pathological diagnosis rate of 61.9%; endometrial cancer in 13 cases, consistent with the pathological diagnosis rate of 92.9%. Conclusion: Hysteroscopy combined with ultrasonography improves the diagnosis of endometrial polyps and submucous fibroids in the etiological diagnosis of postmenopausal endometrial lesions. The diagnosis of endometrial hyperplasia and endometrial cancer, because of mirror positioning curettage, but also improve the diagnostic rate. Hysteroscopy combined with ultrasound examination of intrauterine lesions diagnosis and treatment has important diagnostic value, it is worth promoting the application.