宫腔镜对阴道超声发现子宫内膜异常的诊治价值

The value of hysteroscopic diagnosis and treatment on endometrial lesions were found by transvaginal ultrasonography

目的研究阴道超声发现子宫内膜异常患者的宫腔镜诊治价值。方法对827例经阴道超声检查发现子宫内膜异常的患者行宫腔镜检查,并行诊断性刮宫或宫腔内病变电切,组织物送病检。结果以病检结果为诊断标准,宫腔镜检查对子宫内膜息肉、子宫粘膜下肌瘤、正常子宫内膜、宫颈管息肉及子宫内膜癌的诊断符合率均明显高于阴道超声检查(P<0.01);宫腔镜检查对子宫内膜病变诊断的敏感性和特异性分别是95.23%和86.82%,而阴道超声检查对子宫内膜病变诊断的敏感性和特异性分别是83.99%和41.23%。结论对阴道超声检查发现子宫内膜异常的患者应常规行宫腔镜检查并取组织活检,才能提高诊断符合率,减少误诊和漏诊。

Objective：To study the value of hysteroscopic diagnosis and treatment on endometrial lesions were found by transvaginal uhrasonography（TVS）. Methods：Hysteroscopy（HS ） were performed on 827 patients, Who were already found endometrial diseases by TVS, then diagnostic curettage and/or electrosection and biopsy were performed to intrauterine cavity lesions. Results： Considering histopathological report to be the standard, for diagnosis of endometrial polyps, submucous myoma, normal endometrium, intracervical polyps and endometrial cancer, the diagnose accordance rates of HS were higher significantly compare with TVS （ P 〈 0.01 ） ; Sensitivity and specificity for diagnosis of endometrial lesions were 95.23 % and 86.82 % respectively by HS, whereas by TVS they were 83.99 % and 41 .23% respectively. Conclusion： HS and endometrial biopsy should be conventionally performed for the patients who were found abnormal endometria by TVS, .so that the diagnose accordance rates can be raised, the rates of misdiagnosis and missed diagnosis can be reduced.