【摘要】 目的采用子宫内膜采集器(下称"采集器")进行液基细胞及"有形成份"双重诊断法,分析该方法对于绝经后子宫内膜增厚患者的诊断价值。方法对就诊于上海市浦东新区浦南医院的69例绝经后B超测量子宫内膜≥5mm的患者应用采集器采集子宫内膜组织,将其中颗粒状的"有形成份"浸入10%甲醛液中固定,备组织学诊断,余下部分保存备液基细胞制片细胞学检查;所有患者均随后行诊断性刮宫,以其病理结果作为诊断"金标准",分析采集器细胞学联合"有形成份"组织学的双重诊断法的诊断符合率;比较采集器取材及诊断性刮宫术中的出血量及疼痛程度。结果细胞学联合"有形成份"双重诊断法的诊断符合率为91.3%(63/69);28例患者在未麻醉下进行子宫内膜取样和诊断性刮宫。采集器取样自觉无痛者10例,轻度疼痛者18例,诊断性刮宫均自觉有痛感,其中轻度疼痛者15例,重度疼痛者13例,3例不能耐受转为静脉麻醉下手术;取材过程中采集器出血量平均为(1.34±1.04)ml,诊断性刮宫出血量平均为(11.88±5.04)ml,两者比较差异有统计学意义(P<0.05)。结论子宫内膜采集器细胞学联合"有形成份"组织学检查双重诊断法的诊断符合率较高,基本无痛,出血量少,适用于绝经后子宫内膜增厚的患者。更多还原

【Abstract】 Objective To investigate the clinical value of dual diagnosis of endometrial sampling device in the diagnosis of postmenopausal endometrium thickening. Methods Endometrial sampling devices were used to obtain endometrium of 69 postmenopausal patients with thickening endometrium( ≥5mm) in Punan Hospital in Pudong New Area of Shanghai. Granular endometrium material composition were rinsed in 10% formaldehyde solution to make paraffin sections and the remnant were rinsed in preservation solution for Thin-Cytologic Test and then diagnostic curettages were carried out and the results were considered as standard. The coincidence rate of the dual diagnosis of endometrial sampling device and the difference of volume of blood and pain degree between the two methods were analyzed. Results The diagnostic accordance rate of the dual diagnosis of endometrial sampling device was 91. 3%; 28 cases were taken of samples by endometrial sampling devices and diagnostic curettages without anesthesia,10 cases had no painful feeling and 18 light painful feeling using by endometrial sampling device and 15 cases had light painful feeling and 13 cases severe painful feeling,3cases of them were taken intravenous anesthesia; Volume of blood using endometrial sampling device was( 1. 34 ± 1. 04) ml and that of diagnostic curettage was( 11. 88 ± 5. 04) ml,there was statistical significance between the two groups( P <0. 05). Conclusion Dual diagnosis of endometrial sampling device could improve the diagnostic accordance rate with no painful feeling and few volume of blood, referred to postmenopausal patients with thickening endometrium.更多还原