超声监测联合宫腔镜诊断不孕患者子宫内膜异常的价值

Diagnostic value of transvaginal sonography and hysteroscopy for endometrium disorders in infertility women.

目的探讨阴道超声和宫腔镜检查对不孕患者子宫内膜病变的诊断价值。方法对在我中心不孕门诊进行阴道超声、宫腔镜检查的152例患者分为两组进行对照分析。自然周期超声监测内膜回声异常的105例为研究组,超声监测内膜正常的47例为对照组。结果研究组宫腔镜检查确诊内膜病变为84例(80.00%),对照组为4例(8.51%),两组比较差异有非常显著性意义(P<0.001)。研究组中,子宫内膜息肉占30.48%(32/105),内膜增殖36.19%(38/105),粘膜下肌瘤0.95%(1/105),输卵管阻塞8.57%(9/105),内膜炎症3.81%(4/105);对照组异常内膜为内膜粘连4.25%(2/47),内膜炎症4.25%(2/47)。以宫腔镜结果为金标准,经阴道超声监测对子宫内膜病变诊断的敏感度95.45%(84/88),特异度67.19%(43/64)。研究组确诊内膜异常者84例,妊娠率46.43%(39/84),对照组确诊为内膜正常者43例,妊娠率74.41%(32/43),两组比较差异有显著意义(P<0.05)。结论阴道超声是诊断不孕症患者宫腔内病变的一种简便、廉价、无创伤、诊断率高的方法,可以作为不孕患者宫腔镜检查的初筛,而宫腔镜检查则为内膜病变提供准确的诊断。

Objective： To investigate the diagnostic value of transvaginal sonography and hysteroseopy for the endometrium disorders in infertility women. Methods： The eases of 152 infertility patients, who were checked by transvaginal sonography and hysteroseopy in our center, were analyzed retrospectively. 105 infertility patients whose endometrium resonance were abnormal by uhrasonie monitioring in natural cycle were checked by hysteroseopy （investigate group） , compared with 47 infertility patients whose endometfium were normal （control group） . Results： By hysteroseopy, endometrium changes were diagnosised in 80. 00% in the investigate group and 8.51% in the control group. There were a significant difference between the two groups （ P 〈 0. 001 ） . There were 30.48% （32/105） endometrial polyps, 36.9% （38/105） endometrium hyperplasia, 0. 95% （1/105） submueous myoma, 8.57% （9/105） fallopian tuke obstruction and 3.81% （4/105） inflammation in the investigate group. 4. 5% （2/47） abnomal endometrial changes were intrauterine adhesions and 4. 5% （2/47） were inflammation in the control group; Hysteroseopy results were served as the gold standard, the sensitivity and specificity of transvaginal sonography in detecting endometrium changes were 95.45% （84/88） and 67.19% （43/64） respectively, 84 abnormal endometrium eases were diagnosised in the investigate group and 43 normal endometrium were diagnosised in the eontrol group, the pregnancy rate were 46.43% （39/84） and 74. 41% （ 32/43 ） respectively. There was a significant difference between the two groups （ P 〈 0. 05 ） . Conclusion ： Transvaginal uhrasonography is a simple, economical and non -invasive method with high accuracy, uhrasonie monitioring can be used as an initial diagnostic procedure to select infertility patients for hysteroscopy and hysteroseopy was a accurate method to the diagnose of endometrium disorders.