细胞病理互相沟通，并引进了鳞状上皮内病变（sic）的概念。 1996年11月全国性"宫颈/阴道细胞学
xi bao bing li hu xiang gou tong bing yin jin le lin zhuang shang pi nei bing bian sic de gai nian 1996 nian 11 yue quan guo xing " gong jing / yin dao xi bao xue
同年美国nci提出bethesda（tbs系统）报告方式，该法主要强调将涂片质量，描述性诊断及临床与
tong nian mei guo nci ti chu bethesda tbs xi tong bao gao fang shi gai fa zhu yao qiang diao jiang tu pian zhi liang miao shu xing zhen duan ji lin chuang yu
的五级分类法，全国许多地区至今仍在沿用。1988年who提出应用描述性报告和与cin一致的报告系统。
de wu ji fen lei fa quan guo hu duo di qu zhi jin reng zai yan yong 1988 nian who ti chu ying yong miao shu xing bao gao he yu cin yi zhi de bao gao xi tong
来国内外大多沿用巴氏五级分类法、1978年7月全国宫颈癌防治研究协作会议制订的关于细胞学涂片诊断标准
lai guo nei wai da duo yan yong ba shi wu ji fen lei fa 1978 nian 7 yue quan guo gong jing ai fang zhi yan jiu xie zuo hui yi zhi ding de guan yu xi bao xue tu pian zhen duan biao zhun
。当阴道脱落细胞涂片异常时应做进一步检查。细胞学检查结果可用分级诊断法及描述性诊断法加以表示。长期以
dang yin dao tuo luo xi bao tu pian yi chang shi ying zuo jin yi bu jian cha xi bao xue jian cha jie guo ke yong fen ji zhen duan fa ji miao shu xing zhen duan fa jia yi biao shi chang qi yi
"双取器"刮取宫颈外口鳞柱状上皮交界处一周，涂片后立即固定于95％的酒精中，为克服假阴性可做双份涂片
" shuang qu qi " gua qu gong jing wai kou lin zhu zhuang shang pi jiao jie chu yi zhou tu pian hou li ji gu ding yu 95 de jiu jing zhong wei ke fu jia yin xing ke zuo shuang fen tu pian
一）阴道脱落细胞检查凡已婚妇女在妇科检查及人群防癌普查时均应做阴道脱落细胞涂片。取材时用"小脚板"或
yi yin dao tuo luo xi bao jian cha fan yi hun fu nv zai fu ke jian cha ji ren qun fang ai pu cha shi jun ying zuo yin dao tuo luo xi bao tu pian qu cai shi yong " xiao jiao ban " huo
、有无增厚、日本h动漫结节形成，癌灶浸润是否已达盆壁、盆腔淋巴结有无肿大以及直肠有无浸润等。三、辅助检查 （
you wu zeng hou ri ben h dong man jie jie xing cheng ai zao jin run shi fou yi da pen bi pen qiang lin ba jie you wu zhong da yi ji zhi chang you wu jin run deng san fu zhu jian cha
查时除注意上述情况外，主要检查盆腔后半部及盆壁情况。如宫颈管的粗细和硬度，宫旁组织及宫骶韧带等的弹性
cha shi chu zhu yi shang shu qing kuang wai zhu yao jian cha pen qiang hou ban bu ji pen bi qing kuang ru gong jing guan de cu xi he ying du gong pang zu zhi ji gong di ren dai deng de dan xing
注意有无增厚，肿块、结节、癌灶浸润，组织的质地及活动度等。三合诊日本h动漫是诊断妇科肿瘤不可缺少的检查方法，检
zhu yi you wu zeng hou zhong kuai jie jie ai zao jin run zu zhi de zhi di ji huo dong du deng san he zhen ri ben h dong man shi zhen duan fu ke zhong liu bu ke que shao de jian cha fang fa jian
有无接触性出血等。然后检查子宫体，注意其位置、大小、活动度。质地等。最后检查两侧附件及宫旁结缔组织，
you wu jie chu xing chu xue deng ran hou jian cha zi gong ti zhu yi qi wei zhi da xiao huo dong du zhi di deng zui hou jian cha liang ce fu jian ji gong pang jie di zu zhi
查是妇科检查的常规步骤，先检查阴道壁、宫颈及宫颈管。注意其质地，癌灶的部位。大小、浸润的范围、深度，
cha shi fu ke jian cha de chang gui bu zhou xian jian cha yin dao bi gong jing ji gong jing guan zhu yi qi zhi di ai zao de bu wei da xiao jin run de fan wei shen du
病例局部病灶不明显者，应同时行子宫颈表面及子宫颈管刮片细胞学检查。 3．双日本h动漫合诊及三合诊检查双合诊检
bing li ju bu bing zao bu ming xian zhe ying tong shi hang zi gong jing biao mian ji zi gong jing guan gua pian xi bao xue jian cha 3 shuang ri ben h dong man he zhen ji san he zhen jian cha shuang he zhen jian
滑润剂。要观察阴道穹窿深浅，肿瘤浸润范围，宫颈及其赘生物大小。部位、类型、范围、子宫颈口位置等。早期
hua run ji yao guan cha yin dao qiong long shen qian zhong liu jin run fan wei gong jing ji qi zhui sheng wu da xiao bu wei lei xing fan wei zi gong jing kou wei zhi deng zao qi
和触诊外，要注意外阴部有无癌日本h动漫瘤侵犯及湿疣等病毒感染。 2．窥阴器检查如需作阴道细胞学检查，则以水为
he chu zhen wai yao zhu yi wai yin bu you wu ai ri ben h dong man liu qin fan ji shi you deng bing du gan ran 2 kui yin qi jian cha ru xu zuo yin dao xi bao xue jian cha ze yi shui wei
检查除妇科双合诊外，还需作三合诊检查。检查步骤如下所述，结果要绘图并记录。 1．外阴检查除一般观察
jian cha chu fu ke shuang he zhen wai hai xu zuo san he zhen jian cha jian cha bu zhou ru xia suo shu jie guo yao hui tu bing ji lu 1 wai yin jian cha chu yi ban guan cha
，尤其是锁骨上及腹股沟区等淋巴结；此外还应检查有无远处转移灶，如可疑，应作进一日本h动漫步检查。 （二）妇科
you qi shi suo gu shang ji fu gu gou qu deng lin ba jie ci wai hai ying jian cha you wu yuan chu zhuan yi zao ru ke yi ying zuo jin yi ri ben h dong man bu jian cha er fu ke
）全身检查 首先，观察全身～般情况，有无消瘦、贫血、恶病质等；其次，要仔细检查全身浅表淋巴结有无肿大
quan shen jian cha shou xian guan cha quan shen ban qing kuang you wu xiao shou pin xue e bing zhi deng qi ci yao zai xi jian cha quan shen qian biao lin ba jie you wu zhong da
二、体格检查 包括全身检查及妇科检查。检查应全面、准确、有重点，并日本h动漫按要求填写检查结果。 （一
er ti ge jian cha bao kuo quan shen jian cha ji fu ke jian cha jian cha ying quan mian zhun que you zhong dian bing ri ben h dong man an yao qiu tian xie jian cha jie guo yi
第一章 诊断第一节 诊断步骤 一、询问病史 应详细、完整，并按病历各项内容详细记录，详见附录1，
di yi zhang zhen duan di yi jie zhen duan bu zhou yi xun wen bing shi ying xiang xi wan zheng bing an bing li ge xiang nei rong xiang xi ji lu xiang jian fu lu 1