子宫内膜活检

定义

子宫内膜 活组织检查 is the removal of a small piece of tissue from the lining of the uterus (endometrium) for examination.

选择的名字

活检-子宫内膜

How the Test is Performed

This procedure may be done with or without anesthesia. This is medicine that allows you to sleep during the procedure.

• You lie on your back with your feet in stirrups, similar to having a pelvic exam.
• Your health care provider gently inserts an instrument (speculum) into the vagina to hold it open so that your 子宫颈 可查看. The 子宫颈 is cleaned with a special liquid. Numbing medicine may be applied to the 子宫颈.
• The 子宫颈 may then be gently grasped with an instrument to hold the uterus steady. Another instrument may be needed to gently stretch the cervical opening if there is tightness.
• An instrument is gently passed through the 子宫颈 into the uterus to collect the tissue sample.
• The tissue sample and instruments are removed.
• The tissue is sent to a lab. There, it is examined under a microscope.
• If you had anesthesia for the procedure, you are taken to a recovery area. Nurses will make sure you are comfortable. After you wake up and have no problems from the anesthesia and procedure, you are allowed to go home.

How to Prepare for the Test

考试前:

• Tell your provider about all the medicines you take. These include blood thinners such as warfarin, clopidogrel, and aspirin.
• You may be asked to have a test to make sure you are not pregnant.
• In the 2 days before the procedure, do not use creams or other medicines in the vagina.
• 不要冲洗. (You should never douche. Douching can cause infection of the vagina or uterus.)
• Ask your provider if you should take pain medicine, such as ibuprofen or acetaminophen, just before the procedure.

考试的感觉如何

The instruments may feel cold. You may feel some cramping when the 子宫颈 is grasped. You may have some mild cramping as the instruments enter the uterus and the sample is collected. The discomfort is mild, though for some women it can be severe. However, the duration of the test and the pain are short.

Why the Test is Performed

The test is done to find the cause of:

• Abnormal menstrual periods (heavy, prolonged, or irregular bleeding)
• 出血后 更年期
• Bleeding from taking hormone therapy medicines
• Thickened uterine lining seen on ultrasound
• 子宫内膜癌

正常的结果

The 活组织检查 is normal if the cells in the sample are not abnormal.

What Abnormal Results Mean

Abnormal menstrual periods may be caused by:

• 子宫肌瘤
• Fingerlike growths in the uterus (uterine polyps)
• 感染
• 荷尔蒙失调
• 子宫内膜癌 or precancer (增生)

Other conditions under which the test may be performed:

• Abnormal bleeding if a woman is taking the breast cancer medicine tamoxifen
• Abnormal bleeding due to changes in hormone levels (无卵性的出血)

风险

风险 for endometrial 活组织检查 include:

• 感染
• Causing a hole in (perforating) the uterus or tearing the 子宫颈 (rarely occurs)
• 长期出血
• Slight spotting and mild cramping for a few days

参考文献

Beard JM, Osborn J. Common office procedures. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9日艾德. Philadelphia, PA: Elsevier Saunders; 2016:chap 28.

Soliman PT, Lu KH. Malignant diseases of the uterus: endometrial 增生, 子宫内膜癌, sarcoma: diagnosis and management. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8日艾德. Philadelphia, PA: Elsevier; 2022:chap 32.