采用不同子宫内膜取样器实施子宫内膜活检的诊断价值分析

Analysis of diagnostic accuracy of different endometrial sampling device for endometrial biopsy

目的探讨JUSO子宫内膜取样器和Pipelle子宫内膜取样器在诊断子宫内膜病变的临床应用价值。方法选取2014年6月至2016年2月间北京大学深圳医院妇科门诊需行子宫内膜活检患者210例,采用JUSO(JUSO组,117例)、Pipelle子宫内膜取样器(Pipelle组,93例)及诊断性刮宫(诊刮组)获取子宫内膜组织,比较不同取材手段的取材满意度、病理诊断性、医生操作时间和患者疼痛指数。结果 JUSO组取样器与其诊刮组取材满意度分别为86.32%(101/117)和91.45%(107/117)(P>0.05),Pipelle组与其诊刮组分别为80.65%(75/93)和89.25%(83/93)(P>0.05),两种取样器取材满意度比较,差异均无统计学意义(P>0.05)。JUSO组取样器与其诊刮组诊断正常子宫内膜、子宫内膜息肉、良性子宫内膜增生、子宫内膜癌及非典型增生的准确性比较,差异无统计学意义(P>0.05),Pipelle组及其诊刮组比较,差异无统计学意义(P>0.05)。JUSO组取样器与其诊刮组取材时间分别为(3.87±2.30)min和(10.04±4.98)min(P<0.001),疼痛指数为3.67±2.04和6.86±2.38(P<0.001);Pipelle组取样器与其诊刮组的取材时间为(3.54±2.3)min和(9.84±4.57)min(P<0.001),疼痛指数为2.24±1.86和6.35±2.69(P<0.001)。两种子宫内膜取样器取材时间比较,差异无统计学意义(P>0.05),JUSO子宫内膜取样的患者疼痛指数高于Pipelle子宫内膜取样器(P<0.05)。结论 JUSO子宫内膜取样器和Pipelle子宫内膜取样器进行子宫内膜取材用于病理学检查的临床应用中优于诊刮。

Objective To evaluate clinical significance of JUSO and Pipelle endometrial sampling device in diagnosing the endometrial pathology. Method 210 patients presenting endometrial biopsy were enrolled from June, 2014 to February, 2016 in Peking University Shenzhen Hospital. They were divided into JUSO group（n=117） and Pipelle（n=93） group by simple randomization. An endometrial biopsy collected by endometrial sampling device was performed before dilation and curettage（DC）. Specimen quality, diagnostic accuracy, operative time and pain index were recorded. Results The satisfaction of JUSO group and its DC were 86.32%（n=101） and 91.45 %（n=107）（P=0.212） respectively, while The satisfaction of Pipelle group and its DC were 80.65%（n=75） and 89.25 %（n=83）（P=0.101）. And there was no statistical significance between two different endometrial sampling devices（P〈0.05）. Diagnosing normal ＊endometrium, endometrial polyp, endometrial hyperplasia without atypia, endometrial atypia and endometrial carcinomas, there was no statistical significance between JUSO endometrial sampling device and DC（P〈0.05）, the same as Pipelle and DC, or two different endometrial sampling devices. Sampling time of JUSO and DC were（3.87±2.30） mins and（10.04±4.98） mins（P=0.000）, pain index were 2.24±1.86 and 6.35±2.69（P=0.000）. Sampling time of Pipelle and DC were（3.54±2.3） mins and（9.84±4.57） mins（P=0.000）, and pain index were 2.24±1.86 and 6.35±2.69（P=0.000）. There was no statistical significance of sampling time between different endometrial sampling devices（P=0.830）. But pain index of JUSO was higher than Pipelle（P=0.029）. Conclusion JUSO and Pipelle endometrial sampling device were superior to DC when taking endometrial sampling in clinic.