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目的比较宫腔镜检查及分段诊刮术诊断子宫内膜癌对腹腔冲洗液阳性率的影响。方法选择有腹腔冲洗液结果和完整病理检查资料的子宫内膜癌患者72例,其中宫腔镜组29例,分段诊刮组43例,行手术治疗,开腹后收集冲洗液后即送病理科查找癌细胞。结果腹腔冲洗液阳性者宫腔镜组10例,阳性率为34.5%,高于分段诊刮32.6%(14/34),差异无统计学意义(P>0.05);子宫内膜癌患者腹腔冲洗液阳性与病灶大小明显相关(P<0.05),与组织学类型、浸润程度及转移等无关(P>0.05)。结论宫腔镜有其独特优势,但仍有引起癌细胞进入腹腔的可能,若行宫腔镜检查明确子宫内膜病变时,建议膨宫压力<70 mm Hg(1 mm Hg=0.133 kPa),并尽量缩短检查时间。
Objective To compare the effect of hysteroscopy and segmental curettage on the positive rate of endometrial fluid in the diagnosis of endometrial cancer. Methods Seventy two patients with endometrial cancer who had the results of peritoneal irrigation and the complete pathological examination were selected. Among them, 29 cases were treated by hysteroscopy and 43 cases were treated by segmented diagnosis and curettage group. After the operation, lavage fluid was collected after laparotomy Pathology to find cancer cells. Results The positive rate of intrauterine irrigation in hysteroscopy group was 10 cases, the positive rate was 34.5%, higher than that of 32.6% (14/34) in sub-curettage, the difference was not statistically significant (P> 0.05) Rinsing fluid was positively correlated with the size of the lesion (P <0.05), but not with histological type, degree of infiltration and metastasis (P> 0.05). Conclusions Hysteroscopy has its own unique advantages, but it is still possible to cause cancer cells to enter the abdominal cavity. If hysteroscopy is used to confirm the endometrial lesion, it is suggested that the pressure of the uterus should be less than 70 mm Hg (1 mm Hg = 0.133 kPa) Try to shorten the inspection time.