殷啸俊++++李冉

[摘要]目的 探讨宫腔镜在诊断子宫内膜增厚病变中的应用价值。方法 选取2015年5月～2016年12月在我院就诊的因异常子宫出血行B超检查，提示子宫内膜增厚的患者共120例，其中60例行诊刮术的患者作为诊刮组，60例行宫腔镜检查及治疗的患者作为宫腔镜组。比较分析两组患者子宫内膜增厚的诊断请情况。结果 宫腔镜组在诊断子宫内膜息肉、黏膜下子宫肌瘤及宫腔粘连中与诊刮组比较有更高的检出率，差异有统计学意义（P<0.05）；对子宫内膜息肉、黏膜下子宫肌瘤、子宫内膜增生诊断的敏感度、特异度、阳性预测值、阴性预测值等指标，宫腔镜组高于诊刮组。结论 宫腔镜能直视宫腔内病变，定点取材，诊断准确率高，值得用于子宫内膜增厚的诊断。

[关键词]子宫内膜增厚；宫腔镜；诊刮

[中图分类号] R713.4 [文献标识码] A [文章编号] 1674-4721（2017）07（a）-0115-04

Clinical application of hysteroscopy in patients with endometrial thickening lesions

YIN Xiao-jun LI Ran

Department of Obstetrics and Gynecology，the Second People′s Hospital of Kunshan，Jiangsu Province，Kunshan 215300，China

[Abstract]Objective To investigate the clinical application significance of hysteroscopy in patients with endometrial thickening lesions.Methods 120 patients from May 2015 to December 2016 in our hospital were selected，all the patients received transvaginal ultrasound examinations because of abnormal vaginal bleeding and the ultrasound results showed endometrial thickening.60 cases who were given the diagnostic curettage were selected as the diagnostic curettage group，60 cases received hysteroscopy in in-patient department were selected as the hysteroscopy group.The differences of diagnostic results of the two groups were compared and analyzed.Results The detection rate of endometrial polyp，submucosal myoma of uterus and uterine adhesions in hysteroscopy group was higher than that in the diagnostic curettage group respectively，the difference was statistically significant （P<0.05）；the sensitivity，specificity，positive predictive value and negative predictive value of the endometrial polyp，submucosal myoma of uterus and endometrial hyperplasia in the hysteroscopy group was statistically higher than that in the diagnostic curettage group.Conclusion Hysteroscopy has the advantage of direct sight of intrauterine lesions，drawing target materials and higher diagnosis accuracy，it is worth for the diagnosis of endometrial thickness.

[Key words]Endometrial thickening；Hysteroscopy；Diagnostic curettage

子宮内膜病变大多数是因为患者绝经后阴道流血、异常子宫出血或者患者无异常临床症状，仅B超检查提示子宫内膜增厚被发现，随着检出率的升高越来越受到人们的重视。微小的子宫内膜息肉及直径小于1.0 cm的黏膜下子宫肌瘤，声像图上有时仅显示内膜回声增厚，增强或回声异常，缺乏特异性，需进一步进行病因诊断[1]。子宫内膜病变大多数为良性病变，为妇科的常见疾病，发病率高，因此筛选敏感的子宫内膜疾病的检测手段显得尤为重要[2]。近年来，微创治疗的观念深入人心，宫腔镜检查及治疗的应用普及，给子宫内膜病变的诊疗带来了新的曙光。本研究回顾性分析了我院妇科近一年余因子宫内膜增厚行宫腔镜检查加治疗患者的病例资料，探讨子宫内膜增厚患者应用宫腔镜检查及治疗的临床应用前景。

1资料与方法

1.1一般资料