摘要
目的:探讨影响宫腔镜(HS)对子宫内膜息肉(EMP)诊断的相关因素。方法:回顾分析经手术宫腔镜诊断并治疗的EMP103例,与组织病理学比较,探讨宫腔镜诊断EMP的准确性及其影响因素。结果:103例中69例HS诊断和组织病理学均为EMP,符合率67%,HS漏诊EMP4例,误诊30例。HS诊断EMP与组织病理学的符合率在增生期、分泌期、绝经期分别为56.82%、70.27%、81.82%,增生期与绝经期比较,差异有显著性(P<0.05),增生期与分泌期、分泌期与绝经期比较,差异均无显著性。两者符合率单发性息肉(79.59%)比多发性息肉(60.38%)高,差异有显著性(P<0.05)。直径1～2cm的息肉HS诊断与组织病理学的符合率为83.33%,比<0.5cm和0.5～<1cm的息肉(50%、67.74%)以及>2cm的息肉(66.67%)高,但4组之间差异无显著性。行电切割术的病例中,75.94%的组织病理学诊断为EMP,HS下行钳夹或刮宫术的病例中54.17%的组织病理学提示EMP,差异有显著性(P<0.05)。结论:HS诊断EMP的准确率受月经周期、息肉数量及手术方式的影响,必须结合组织病理学检查。
Objective：To study the related factors in hysteroscopic diagnosis of endometrial polyps（EMP）.Methods： The diagnostic accordance between hysteroscopy（HS） and histopathology was studied restrospectively in 103 cases of EMP underwent HS.Results： Diagnoses of HS were in accordance with histopathologies in 69 cases out of 103 cases.There were different diagnoses between HS and histopathology in 34 cases,in which, four cases were diagnosed as EMP by histopathologies.The accordance between HS and histopathology in diagnosing EMP was 56.82% in proliferative phase,70.27% in secretive phase and 81.82% in postmenopause respectively.There was significant difference between the accordance in proliferative phase and that in postmenopause（P〈0.05 ）.The accordance in single EMP was higher than that in mutipie EMPs（P〈0.05）.The accordance in EMP of 1-2 cm（83.33%） was better tban that in smaller EMP（50% ,67.74% ）and bigger EMP（66.67% ）, but there was no significant differences between them, Sixty cases （75.94%） were diagnosed as EMP by histopatholugies out of 79 cases of TCRPs.Thirteen cases （54.17%） were diagnosed as EMP by histopatholugies out of 24 cases with curettages under HS.There was significant difference between them （P〈0.05）.Conclusion： Correct hysteroscopic diagnosis of EMP may be influenced by many factors,such as menstrual phase, number of EMP and the operation method.It is suggested that hysteroscopie diagnosis of EMP should be combined with histopathology.
出处
《现代妇产科进展》
CSCD
北大核心
2005年第4期300-303,共4页
Progress in Obstetrics and Gynecology
