经阴道超声联合宫腔镜对子宫内膜息肉诊断价值分析

Analysis of the diagnostic value of transvaginal ultrasound combined with hysteroscopy in endometrial polyps

目的:探讨经阴道超声联合宫腔镜对子宫内膜息肉诊断价值,并分析诊断准确性的影响因素。方法:选取2019-01~2022-03我院接诊的189例疑似子宫内膜息肉患者进行研究。所有患者均行经阴道超声及宫腔镜检查,根据经阴道超声联合宫腔镜与病理学检查结果相符性将患者分为两组,比较两组年龄、BMI指数、息肉最大径、近期流产史、合并子宫肌瘤、合并子宫腺肌症、剖宫产史,再以多因素Logisitic回归分析筛选出影响经阴道超声联合宫腔镜诊断准确性的影响因素。结果:经阴道超声联合宫腔镜对子宫内膜息肉诊断灵敏度为82.93%(102/123),特异度为87.88%(58/66),Kappa=0.677(P<0.05),经阴道超声联合宫腔镜检查与病理结果共有160例相符。多因素分析结果显示:息肉最大径、近期流产史、合并子宫肌瘤及剖宫产史为经阴道超声联合宫腔镜对子宫内膜息肉诊断准确性的独立性影响因素(P<0.05)。结论:经阴道超声联合宫腔镜对子宫内膜息肉诊断准确性受息肉最大径、近期流产史、合并子宫肌瘤及剖宫产史的影响,临床诊断时应注意对上述因素的综合分析。

Objective:To investigate the diagnostic value of transvaginal ultrasound combined with hysteroscopy in the diagnosis of endometrial polyps,and to analyze the influencing factors of diagnostic accuracy.Methods:A total of 189 patients with suspected endometrial polyps admitted to our hospital from January 2019 to March 2022 were selected for research.All patients underwent transvaginal ultrasound and hysteroscopy.The patients were divided into two groups according to the consistency of the results of transvaginal ultrasound combined with hysteroscopy and pathological examination.The age,BMI index,maximum diameter of polyps,recent history of abortion,uterine fibroids,adenomyosis,and history of cesarean section were compared between the two groups.Multivariate Logisitic regression analysis was used to screen out the influencing factors affecting the diagnostic accuracy of transvaginal ultrasound combined with hysteroscopy.Results:The sensitivity of transvaginal ultrasound combined with hysteroscopy in the diagnosis of endometrial polyps was 82.93%(102/123),the specificity was 87.88%(58/66),and Kappa=0.677(P<0.05).A total of 160 cases were consistent with the results of laparoscopy and pathology.The results of multivariate analysis showed that the largest diameter of polyps,recent history of abortion,combined uterine fibroids and history of cesarean section were the independent influencing factors for the diagnostic accuracy of endometrial polyps by transvaginal ultrasound combined with hysteroscopy(P<0.05).Conclusion:The accuracy of transvaginal ultrasonography combined with hysteroscopy in the diagnosis of endometrial polyps is affected by the maximum diameter of polyps,recent history of miscarriage,combined uterine fibroids and history of cesarean section,and comprehensive analysis of the above factors should be paid attention to in clinical diagnosis.