宫腔镜联合经阴道超声在子宫内膜病变诊断中的应用与价值

Application and Value of Hysteroscopy Combined with Transvaginal Ultrasound in the Diagnosis of Endometrial Lesions

目的:探讨宫腔镜联合经阴道超声在子宫内膜病变诊断中的应用效果。方法:117例疑似子宫内膜病变患者,入院后行阴道彩超及宫腔镜检查及子宫内膜病理检查,比较阴道超声及宫腔镜检查的结果。结果:117例疑似子宫内膜病变患者中106例(90.60%)经病理检查证实子宫内膜病变,11例(9.40%)患者子宫内膜正常。阴道超声、宫腔镜、二者联合检查在子宫内膜癌诊断准确率方面比较,差异无统计学意义,P>0.05;宫腔镜在子宫内膜增生、子宫内膜息肉及子宫内膜炎方面较阴道超声准确高;阴道超声在子宫黏膜下肌瘤诊断准确率方面高于宫腔镜检查,阴道超声联合宫腔镜检查在子宫黏膜下肌瘤、子宫内膜增生、子宫内膜息肉、子宫内膜炎方面均高于阴道超声、宫腔镜检查,差异有统计学意义,P<0.05。在灵敏度、阳性预测值方面,阴道超声、宫腔镜检查、阴道超声联合宫腔镜检查差异无统计学意义,阴道超声联合宫腔镜检查的特异性、阴性预测值、准确性均高于单纯阴道超声或宫腔镜检查。结论:宫腔镜检查诊断子宫内膜病变特异性好、准确率高,阴道超声检查无创、简单,二者结合是临床诊断子宫内膜病变的最佳手段。

Objective： To explore the effect of hysteroscopy combined with transvaginal ultrasound in the diagnosis o f e n d o m e t r i a l l e s i o n s. M e t h o d s ： 117 cases of suspected endometrial lesions, admission to hospital after transvaginal ultrasound and hysteroscopy and endometrial pathological examination, compared with the results of transvaginal ultrasound and hysteroscopy.Results：106 cases（90.60%） were confirmed by pathological examination in 117 cases with suspected endometrial lesions, and 11 cases（9.40%） were normal. Transvaginal ultrasound and hysteroscopy, two joint examination in the diagnosis of endometrial cancer accurate rate comparison, the difference was not statistically significant, P〈0.05; hysteroscopy is high in accuracy of transvaginal ultrasound in endometrial hyperplasia and endometrial polyps and endometritis; transvaginal ultrasonography in diagnosis of submucosal myoma of uterus is higher than the accuracy of transvaginal ultrasound combined with hysteroscopy. Hysteroscopy in the submucosal uterine fibroids, endometrial hyperplasia and endometrial polyps, endometritis were significantly higher than that of transvaginal ultrasound and hysteroscopy, the difference was statistically significant, P〈0.05. In the sensitivity, positive predictive value, no statistical significance of transvaginal ultrasound and hysteroscopy, transvaginal ultrasound combined with hysteroscopy in difference, specificity, negative transvaginal ultrasound combined with hysteroscopy in the predictive value, accuracy was higher than the transvaginal ultrasonography or hysteroscopy. Conclusion： Hysteroscopy in the diagnosis of endometrial lesions with good specificity, high accuracy, transvaginal ultrasound examination is non-invasive, simple, the combination of the two is the best means of clinical diagnosis of endometrial lesions.