宫腔镜检查在异常子宫出血诊断中的临床价值

Clinical value of hysteroscopy in the diagnosis of abnormal uterine bleeding

目的研究宫腔镜检查在异常子宫出血(AUB)患者诊断中的临床价值。方法选取261例AUB患者,均采用内膜活检行组织学病理诊断,分析宫腔镜检查的诊断价值。其中临床诊断子宫内膜息肉共141例,均行宫腔镜检查及经阴道B超检查,以组织病理学诊断结果为金标准,比较两种检查方式的诊断价值。结果所有患者行宫腔镜检查及内膜活检组织病理学诊断后,其中宫腔镜诊断发现子宫内膜息肉患者112例,与组织病理学诊断符合率为57.14%,子宫黏膜下肌瘤18例,病理学诊断符合率为16.67%,子宫内膜恶性肿瘤7例,病理学诊断符合率为71.43%,子宫内膜增生108例,病理学诊断符合率为19.44%。其中,宫腔镜检查对子宫内膜息肉的特异性及阴性预测值均高于经阴道B超检查,差异有统计学意义(P<0.05)。结论宫腔镜检查对于AUB患者的诊断价值较高,与经阴道B超相比,宫腔镜对于子宫内膜息肉检查具有较高的特异性及阴性预测值,可以降低误诊率,可以做出更好的早期诊断。

Objective To investigate the clinical value of hysteroscopy in the diagnosis of abnormal uterine bleeding(AUB).Methods Endometrial biopsy was performed in 261 patients with AUB,and the diagnostic value of hysteroscopy was analyzed.A total of 141 cases of endometrial polyps were clinically diagnosed,and all of them were examined by hysteroscopy and transvaginal B-ultrasound.The diagnosis results of histopathology were taken as the gold standard,and the diagnostic value of the two methods was compared.Results All patients after hysteroscopy and endometrial biopsy tissue pathology diagnosis,which found hysteroscopy in the diagnosis of endometrial polyps,112 cases of patients,and histopathological diagnosis coincidence rate was 57.14%,the submucosal uterine fibroids 18 cases,pathological diagnosis coincidence rate was 16.67%,7 cases of endometrial malignancy,pathological diagnosis coincidence rate was 71.43%,There were 108 cases of endometrial hyperplasia,and the coincidence rate of pathological diagnosis was 19.44%.The specificity and negative predictive value of hysteroscopy for endometrial polyps were higher than those of transvaginal B-ultrasound,and the differences were statistically significant(PV0.05).Conclusion Hysteroscopy in the diagnosis and classification of abnonnal uterine bleeding,has higher application value of the disease.Compared with transvaginal ultrasound,the specific degree and negative predictive value of hysteroscopy examination is high,the patients with abnormal uterine bleeding can make better eliminate diagnosis and follow-up treatment.