阴道超声与宫腔镜联合检查对子宫异常出血患者的诊断价值探讨

Diagnostic value of combined vaginal ultrasonography and hysteroscopy on patients with abnormal uterine bleeding

目的探讨子宫异常出血(AUB)患者采取阴道超声联合宫腔镜检查的价值。方法选择AUB患者280例,均接受过阴道超声、宫腔镜检查,将病理结果作为标准,比较阴道超声、宫腔镜单一检查及二者联合检查的价值。结果联合检查AUB检出率高于阴道超声或宫腔镜单一检查,宫腔镜检查AUB检出率高于阴道超声检查;联合检查各类病理类型检出率高于阴道超声或宫腔镜检查,而宫腔镜诊断子宫内膜增厚、子宫黏膜下肌瘤、子宫内膜息肉符合率高于阴道超声,阴道超声检查增生期子宫内膜检出率高于宫腔镜诊断;联合诊断灵敏度、特异度、准确度高于阴道超声或宫腔镜单一检查,宫腔镜检查灵敏度与特异度高于阴道超声(P<0.05)。结论AUB采取阴道超声、宫腔镜检查均有一定的价值,但二者检查不同病理类型检出率存在差异,二者联合检查可进一步提高检查检出率,以及联合检查灵敏度、特异度及准确度更高,值得临床应用。

Objective To explorethe value of vaginal ultrasonography combined with hysteroscopy on patients with abnormal uterine bleeding(AUB).Methods 280 patients with AUB were selected and underwent transvaginal ultrasonography and hysteroscopy.The pathological result was used as the standard to compare the value of vaginal ultrasonography,hysteroscopy and the combination of the two.Results The detection rate of AUB in combined examination was higher than that in vaginal ultrasonography or hysteroscopy alone,and the detection rate of AUB in hysteroscopy was higher than that in vaginal ultrasonography.The detection rates of various pathological types in combined examination were higher than those in vaginal ultrasonography or hysteroscopy,and the coincidence rate of hysteroscopy was higher than that of vaginal ultrasonography in the diagnosis of endometrial thickening,uterine submucous myoma and endometrial polyps,and the detection rate of proliferative phase endometrium in vaginal ultrasonography was higher than that in hysteroscopy.The sensitivity,specificity and accuracy of combined diagnosis were higher than those of vaginal ultrasonography or hysteroscopy alone,and the sensitivity and specificity of hysteroscopy were higher than those of vaginal ultrasonography(P<0.05).Conclusion Vaginal ultrasonography and hysteroscopy are valuable for AUB,but there are differences in the detection rates of different pathological types between them.The combined examination of the two can further enhance the detection rate,and the combined examination has higher sensitivity,specificity and accuracy.