国际生殖健康/计划生育 ›› 2017, Vol. 36 ›› Issue (3): 234-237.

• 讲座 • 上一篇    下一篇

慢性子宫内膜炎的宫腔镜诊断

宋冬梅,黄晓武   

  1. 100038 北京,首都医科大学附属复兴医院
  • 收稿日期:2017-04-10 修回日期:2017-04-17 出版日期:2017-05-15 发布日期:2017-05-15
  • 通讯作者: 黄晓武,E-mail:hxiaowu_ fxyy@126.com E-mail:hxiaowu_fxyy@126.com
  • 基金资助:
    首都医科大学基础-临床科研合作基金(15JL63)

Hysteroscopic Diagnosis of Chronic Endometritis

SONG Dong-mei,HUANG Xiao-wu   

  1. Fuxing Hospital,Capital Medical University,Beijing 100038,China
  • Received:2017-04-10 Revised:2017-04-17 Published:2017-05-15 Online:2017-05-15
  • Contact: HUANG Xiao-wu,E-mail:hxiaowu_ fxyy@126.com E-mail:hxiaowu_fxyy@126.com

摘要: 慢性子宫内膜炎因症状的非特异性而被临床忽视,但因其对女性生殖预后以及异常子宫出血的影响而渐被关注。慢性子宫内膜炎的宫腔镜下特征:局灶或弥漫性腺体周围充血;子宫内膜间质水肿,与月经周期不符的子宫内膜增厚、泛白、表面不规则;子宫内膜微小息肉(小于1 mm),带蒂并伴有基质水肿、局灶或弥漫性的腺体周围充血的息肉。宫腔镜诊断慢性子宫内膜炎的准确性受膨宫介质以及检查者经验的影响,其与组织病理学诊断的符合率差异很大。宫腔镜评价慢性子宫内膜炎的价值已得到认可,但能否独立作为慢性子宫内膜炎的诊断标准仍有争议。宫腔镜检查提示慢性子宫内膜炎的女性需要进一步明确组织病理学诊断,减少因漏诊导致慢性子宫内膜炎的持续存在对女性生殖预后的影响。

关键词: 子宫内膜炎, 充血, 息肉, 水肿, 慢性子宫内膜炎, 子宫内膜充血, 子宫内膜微小息肉, 子宫内膜间质水肿, 宫腔镜, 诊断

Abstract: Chronic endometritis was often overlooked because of its nonspecific symptoms. However, it has drawn more and more attention recently because of its influence on female reproductive prognosis, and abnormal uterine bleeding. Clinical features of chronic endometritis under hysteroscopy were as follows: ①focal or diffuse periglandular hyperemia; ②endometrial stromal edema, increased thickness of the endometrium, with whitish color and irregular surface, and out of phase; ③pedunculated micropolyps (less that 1 mm), stromal edema, or micropolyps with focal or diffuse periglandular hyperemia. The accuracy of hysteroscopic diagnosis of chronic endometritis is affected by the media and doctor′s experience. There is a great difference between the hysteroscopic diagnosis and the pathological diagnosis. The value of hysteroscopy in the evaluation of chronic endometritis has been recognized, but it is still controversial whether hysteroscopy can be used as an independent diagnostic criteria for chronic endometritis. The histopathological diagnosis should be advised if chronic endometritis is clinically suspected under hysteroscopy, so as to reduce the influence of the persistent chronic endometritis on female reproductive prognosis.

Key words: Endometritis, Hyperemia, Polyps, Edema, Chronic endometritis, Endometrial hyperemia, Endometrial micropolyps, Endometrial stromal edema, Hysteroscopes, Diagnosis