宫腔镜检查在异常子宫出血诊断中的应用价值

Application Value of Hysteroscopy in Diagnosis of Abnormal Uterine Bleeding

目的分析异常子宫出血患者诊断中采用宫腔镜检查的临床价值。方法方便选取2014年1月—2016年12月在该院就诊的90例异常子宫出血患者作为该次实验研究对象,90例异常子宫出血患者首先安排阴道超声检查,然后安排宫腔镜检查,选择异常子宫内膜实施病理检查,以病理检查结果为标准对比阴道超声检查以及宫腔镜检查两种检查方式的阳性检出率。结果两种检查方式和病理检查结果都有所误差,但宫腔镜检查中阳性率(90.00%)显著高于阴道超声检查(74.40%),两组对比差异有统计学意义(P<0.05)。宫腔镜检查内膜非特异性病变敏感性(94.61%)、子宫内膜增殖症敏感性(92.91%)显著高于阴道超声检查76.98%、39.31%,两种检查方式对子宫内膜息肉、子宫粘膜下肌瘤、子宫内膜癌的敏感性差异无统计学意义(P>0.05)。结论异常子宫出血采用宫腔镜检查的阳性预测值更高,可更好的了解患者实际病情,为临床诊断提供了科学可靠依据,可作为临床诊断异常子宫出血的重要手段。

Objective To analyze the application value of hysteroscopy in diagnosis of abnormal uterine bleeding. Methods Convenient selection 90 cases of patients with abnormal uterine bleeding diagnosed in our hospital from January 2014 to December 2016 were selected and firstly examined by the vaginal ultrasound and then examined by the hysteroscopy, and the abnormal endometrium was given the pathological examination and the positive test rate of the two method was compared taking the pathological examination results as the standards. Results The two examination methods and pathological examination results had the errors, but the positive rate of hysteroscopy examination was obviously higher than that of vaginal ultrasound examination(90.00% vs 74.40%), and the difference between groups was statistically significant(P<0.05), and the sensitivities of hysteroscopy examination of non-specificity lesions and hyperplasia of endometrium were obviously higher than those of the vaginal ultrasound examination(94.61%, 92.91% vs 76.98% 、39.31%), and the differences in the sensitivities to endometrial polyp, submucosal uterine fibroids and carcinoma of endometrium between the two examination methods were not statistically significant(P>0.05). Conclusion The positive predictive value of hysteroscopy examination of abnormal uterine bleeding is higher, which can better master the practical disease condition thus providing a scientific and reliable basis for the clinical diagnosis, and it can be used as an important means of clinical diagnosis of abnormal uterus.