腹腔镜检查在子宫内膜异位症早期筛查中的临床价值

Clinical value of laparoscopic diagnosis in early screening endometriosis

目的研究评价腹腔镜检查在不孕或慢性盆腔疼痛患者行子宫内膜异位症早期筛查中的临床价值。方法选取该院妇科因不孕和慢性盆腔疼痛而接受腹腔镜检查的128例患者作为研究对象。比较腹腔镜检查与组织病理学检查在子宫内膜异位症早期筛查结果。并根据美国生育协会(American fertility society,AFS)子宫内膜异位症分期标准,检验腹腔镜检查诊断的准确率。结果腹腔镜检查的灵敏度为97.1%,特异度为67.8%,阳性预测值为77.9%,阴性预测值为95.2%,准确率为83.6%。对分期的诊断准确率为Ⅰ期为86.7%,Ⅱ期为85.2%,Ⅲ期为81.3%,Ⅳ期为86.7%。结论采用腹腔镜检查子宫内膜异位症其灵敏度、阴性预测值较高,但特异度、阳性预测值和准确率相对较低。总体来说,腹腔镜检查对早期诊断筛查病例具有较高临床价值。

[Objective ] To study and evaluate the clinical value of laparoscopy in early screening of endometriosis. [Methods ] 128 patients given laparoscopic examination because of infertility and chronic pelvic pain were selected as the research subjects in gynecological department of our hospital.The results of laparoscopy and pathological examination in endometriosis early screening were compared. And according to the AFS endometriosis staging standard, the accuracy of laparoscopic diagnosis was checked. [ Results ] Sensitivity of laparoscopie exami- nation was 97.1%, specificity was 67.8%, positive predictive value was 77.9%, negative predictive value was 95.2%, the accuracy was 83.6%. The accuracy of staging diagnosis was as follows： period Ⅰ was 86.7%, period Ⅱ was 85.2%, period Ⅲ was 81.3%, period Ⅳ was 86.7%. [Conclusion] The sensitivity and negative predictive value of laparoscopic endometriosis is high, but the specificity, positive predictive value and accuracy were relatively low. In general, laparoscopy has a highly clinical value in early screening of endometriosis.