目的:探讨宫腔镜对绝经后异常子宫出血的诊断及治疗价值。方法:对90例绝经后出血的患者进行宫腔镜检查,分析导致绝经后出血的宫腔内因素。对镜下诊断为子宫粘膜下肌瘤、子宫内膜息肉、子宫颈肌瘤及息肉的47例行宫腔镜手术治疗,9例子宫内膜癌患者接受开腹手术,并最终获得组织病理诊断。随诊观察手术疗效。结果:绝经后异常子宫出血的原因以子宫腔内良性占位病变居首位(子宫内膜息肉27例,子宫粘膜下肌瘤7例,宫颈管息肉13例)共47例,其次是萎缩性子宫内膜炎共31例,子宫内膜癌为第3位共9例。绝经后良性宫腔占位47例均采用宫腔镜手术治疗,手术时间短,创伤小,术后恢复快,无一例手术并发症。结论:宫腔镜检查直观准确,是绝经后异常子宫出血病因检查的首选方法;宫腔镜手术创伤小、疗效高,是目前治疗绝经后宫腔良性占位所致异常子宫出血的最佳方法。 Objective: To investigate the value of hysteroscopy in the diagnosis and treatment of abnormal uterine bleeding after menopause. Methods: Hysteroscopy was performed in 90 patients with postmenopausal bleeding to analyze the intrauterine factors leading to postmenopausal bleeding. Of the 47 cases diagnosed as submucous uterine fibroids, endometrial polyps, cervical fibroids and polyps by hysteroscopic surgery, 9 cases of endometrial cancer patients underwent open surgery, and finally obtained histopathological diagnosis. Follow-up observation of surgical efficacy. Results: The causes of abnormal uterine bleeding in postmenopausal women with benign occupying lesions in uterine cavity occupy the first place (27 cases of endometrial polyps, uterine fibroids in 7 cases, 13 cases of cervical polyp) in 47 cases, followed by atrophy Endometritis in 31 cases, endometrial cancer in the third place in a total of 9 cases. Postmenopausal benign uterine cavity occupying 47 cases were treated by hysteroscopic surgery, the operation time is short, less trauma, postoperative recovery, no case of surgical complications. Conclusion: The hysteroscopy is accurate and accurate, which is the first choice for etiological examination of abnormal uterine bleeding in postmenopausal women. Hysteroscopic surgery with small trauma and high curative effect is the best method for treating abnormal uterine bleeding caused by benign uterine cavity occupying in postmenopausal women.