宫腔镜技术在异常子宫出血患者诊疗中的应用价值

The Value of Hysteroscopic Technique in the Diagnosis and Treatment of Patients with Abnormal Uterine Bleeding

目的分析异常子宫出血患者应用宫腔镜技术的诊疗价值。方法以2018年2月—2019年2月50例在该院进行异常子宫出血诊治的患者为研究对象,为所有患者实施阴道超声检查以及宫腔镜检查。结果病理诊断结果显示5例子宫内膜癌、11例子宫黏膜下肌瘤、14例子宫内膜息肉、20例子宫内膜增生、1例正常子宫内膜。阴道超声检查子宫内膜增生准确率为88.00%、特异度为86.67%、敏感度为90.00%,子宫内膜息肉分别为85.71%、91.67%、64.29%子宫黏膜下肌瘤分别为98.00%、97.50%、100.00%,子宫内膜癌分别为88.00%、97.50%、100.00%。宫腔镜检查子宫内膜增生准确率为94.00%、特异度为93.33、敏感度为95.00%,子宫内膜息肉分别为96.00%、97.22%、92.86%,子宫黏膜下肌瘤分别为98.00%、97.50%、100.00%,子宫内膜癌分别为96.00%、95.56%、100.00%。宫腔镜检查子宫内膜增生、子宫内膜息肉、子宫内膜癌准确率明显高于阴道超声检查,差异有统计学意义(P<0.05),子宫黏膜下肌瘤检查准确率,差异无统计学意义(P>0.05)。两种检查方式子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤以及子宫内膜癌纳差特异度,差异无统计学意义(P>0.05),宫腔镜检查子宫内膜息肉以及子宫内膜癌检查敏感度明显高于阴道超声检查,差异有统计学意义(P<0.05),两种检查方式子宫内膜增生、子宫黏膜下肌瘤检查敏感度差异无统计学意义(P>0.05)。结论异常子宫出血患者应用宫腔镜技术临床诊断价值较高,有助于提高疾病检出率,从而可为临床医生为患者实施有效的病情诊治提供重要依据和参考。

Objective To analyze the value of hysteroscopy in the diagnosis and treatment of patients with abnormal uterine bleeding.Methods From February 2018 to February 2019,50 patients who underwent abnormal uterine bleeding in our hospital were enrolled in the study.All patients underwent vaginal ultrasonography and hysteroscopy.Results The results of pathological diagnosis showed 5 cases of endometrium cancer,11 cases of uterine submucosal fibroids,14 cases of endometrial polyps,20 cases of endometrial hyperplasia,1 case of normal endometrium.The accuracy of vaginal ultrasonography for endometrial hyperplasia was 88.00%,the specificity was 86.67%,the sensitivity was 90.00%,and the endometrial polyps were 85.71%,91.67%,and 64.29%,respectively.The uterine submucosal fibroids were 98.00%and 97.50%,100.00%,endometrial cancer was 88.00%,97.50%,100.00%,respectively.The accuracy of hysteroscopy for endometrial hyperplasia was 94.00%,the specificity was 93.33%,the sensitivity was 95.00%,the endometrial polyps were 96.00%,97.22%,92.86%,and the uterine submucosal fibroids were 98.00%,97.50%,100.00%,endometrial cancer was 96.00%,95.56%,100.00%.The accuracy of hysteroscopy for endometrial hyperplasia,endometrial polyps,and endometrial cancer was significantly higher than that of vaginal ultrasonography,the difference was statistically significant(P<0.05).The accuracy of uterine submucosal myoma was not statistically significantly different(P>0.05).There were no significant differences in the specificity of endometrial hyperplasia,endometrial polyps,uterine submucosal fibroids and endometrial cancer between the two methods(P>0.05),hysteroscopic endometrial polyps and endometrial cancer.The sensitivity of the examination was significantly higher than that of the vaginal ultrasound examination.The difference was statistically significant(P<0.05).There was no significant difference in the sensitivity of the endometrial hyperplasia and uterine submucosal myoma between the two examinations(P>0.05).Conclusion The clinical diagnosis of hysteroscopic technique in patients with abnormal uterine bleeding is of high value,which can help to improve the detection rate of the disease,which can provide an important basis and reference for clinicians to implement effective diagnosis and treatment of patients.