宫腔镜、B超检查对异常子宫出血的诊断价值

The value of hysteroscopy and B ultrasonic in diagnosing of abnormal uterine bleeding

目的探讨宫腔镜、B超在诊断异常子宫出血中的应用价值。方法回顾分析2003年6月～2005年6月初诊为异常子宫出血并进行了B超、电子宫腔镜检查的115例病例。结果B超报告子宫内膜正常者63例,宫腔镜诊断宫内膜息肉2例、增殖期子宫内膜6例、宫颈管小息肉2例,病理报告与宫腔镜诊断相符。B超发现异常情况52例,经宫腔镜检查活检、诊刮的病理报告异常的有37例,宫腔镜对诊断宫内膜息肉、子宫肌瘤、宫内膜癌的准确性较高分别达100%、87.5%、100%,宫腔镜诊断宫内膜增生、宫内膜萎缩的准确性分别达59.09%、50%。宫腔镜诊断子宫异常出血的漏诊率为0,腹部B超检查的敏感性为91.30%,漏诊率8.70%。结论宫腔镜检查只有结合B超并与定位组织活检、诊刮相结合,才能提高对宫腔内疾病诊断的准确性。

Objective To evaluate hystemscopy and B ultrasonic in the diagnosis of abnormal uterine bleeding （AUB）. Methods Retrospective analyze 115 patients that preliminary diagnosesed of AUB from 2003.6 to 2005.6. Results 63 cases were reported by B ultrasonic as normal endometrium. As to hysteroscopy, 10 cases were reparted abnormal. Pathological repot were match to the hysteroscopy diagnoses. Among 52 cases that diagnoseced abnormal by B ultrasonic, 37cases were reported abnormal by pathological report by hysteroscopy and localizational endometrial biopsy or endometrial curettage. AS to the diagnoses of endometfial polyp, hysteromyoma and endometrial carcinoma, the hystemscopy had anaccuracy of 100%, 87.5% and 100% respectively. As to the diagnoses of endometrial hyperplasia and atrophic endometrium, the hysteroscopy had an accuracy of 59.09% and 50%. AS to the diagnosis of AUB, the rate of missed diagnosis is 0 with hysteroscopy, B ultrasonic of abdominal combined with vagina had a sensidvity of 91.30%, and hada rate of missed diagnosis of 8.70%. Conclusions The hysteroscopy must combined with B ultrasonic, tissue pathological examination of localizational endometrial biopsy or endometrial curettage to improve the accuracy of diagnosisof endometfial disease.