阴道镜检查宫颈疾病186例临床分析

Clinical analysis of the Colposcopy for the cervical diseases in 186 cases

目的评价阴道镜检查对宫颈疾病诊断的价值。方法对经阴道镜检查的186例患者再在镜下定点活检。结果经病理检查证实慢性宫颈炎150例,宫颈息肉13例,宫颈湿疣5例,宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)15例,(CINⅠ10例,CINⅡ3例,CINⅢ2例),宫颈癌3例。临床诊断宫颈湿疣2例,阴道镜下诊断宫颈湿疣6例(5例已经病理证实,误诊1例),阴道镜下诊断CIN45例,已经病理证实为CIN15例(病理诊断为慢性宫颈炎的30例)。结论电子阴道镜作为一种临床诊断方法,其诊断的准确性与阴道镜图像的特异性,阴道镜医生的经验技术,活检标本的大小等因素有关。借助电子阴道镜使病变图像清晰更方便定位活检,对CIN早期诊断,早期治疗及降低宫颈癌的发生率有重要价值。

Objective To evaluate the colposcopy diagnosis for cervical diseases.Methods Totally 186 cases examined by the colposcopy and fixed-point in endoscopic biopsy.Results The pathological findings showed chronic cervicitis in 150 cases,cervical polyps in 13 cases,cervical condyloma in 5 cases,cervical intraepithelial neoplasia（CIN）in 15 cases（including 10 cases with CIN I,3 cases with CIN Ⅱ,2 cases with CIN Ⅲ）and cervical cancer in 3 cases.Cervical condyloma by clinical diagnosis were 2 cases,cervical condyloma diagnosed by the colposcopy in 6 cases（5 cases confirmed by pathology and 1 case missed diagnosis accounting for 16%）.Forty-five cases were diagnosed by the colposcopy while only 15 cases were confirmed by pathology another 30 cases were confirmed as chronic cervicitis by pathology that diagnostic accordance rate was 33.33%.Conclusion The diagnostic accuracy of the colposcopy examination was related to the specificity of colposcopy images,the experience and the technology of the colposcopy doctors,the size of the biopsy specimens and others factors.Early diagnosis,early treatment for the patients with CIN and reducing incidence of cervical cancer has important value by the colposcopy making the image more clear and more convenient to get lesions biopsy fixed-point.