宫腔镜及超声对围绝经期异常子宫出血患者的诊断价值

Diagnostic value of hysteroscopy and ultrasound in patients with abnormal uterine bleeding during perimenopause

目的:探究宫腔镜及超声对围绝经期异常子宫出血患者的诊断价值。方法:将2020年1月~2022年12月我院收治的76例疑似围绝经期异常子宫出血患者作为研究对象。以病理检查结果为金标准,通过金标准检查确诊62例。对所有患者进行宫腔镜和超声检查,对比宫腔镜及超声检查结果与病理检查结果的一致性,判断诊断效能,比较宫腔镜及超声检查诊断围绝经期异常子宫出血病因与病理符合情况。结果:超声检查共检出阳性病例,55例,检查结果与病理检查结果Kappa值为0.449,一致性较差。宫腔镜检查共检出阳性病例60例,检查结果与病理检查结果Kappa值为0.751,一致性较好。超声检查对围绝经期异常子宫出血的诊断的敏感度、特异度和准确率分别为82.26%、71.43%、80.26%;宫腔镜检查的敏感度、特异度和准确率分别为93.55%、85.71%、92.11%。宫腔镜及超声检查对黏膜下子宫肌瘤和子宫内膜息肉引起的异常子宫出血的病因诊断差异无统计学意义(P>0.05)。宫腔镜对子宫内膜增生的病因诊断效果高于超声检查(P<0.05)。结论:宫腔镜能有效诊断围绝经期异常子宫出血及病因的诊断效能,具有较高的诊断符合率。

Objective:To explore the diagnostic value of hysteroscopy and ultrasound in patients with abnormal uterine bleeding during perimenopause.Methods:76 patients with suspected abnormal perimenopausal uterine bleeding admitted to our hospital from January 2020 to December 2022 were studied.Based on the results of pathological examination,62 cases were confirmed by gold standard examination.Hysteroscopy and ultrasound were performed on all patients,and the consistency of the results of hysteroscopy and ultrasound with the results of pathological examination was compared to judge the diagnostic efficiency,and the etiology and pathological conformity of the diagnosis of abnormal uterine bleeding in perimenopause by hysteroscopy and ultrasound were compared.Results:A total of 55 positive cases were detected by ultrasound examination,and the Kappa value of the examination results and pathological examination results was 0.449,which was poor consistency.A total of 60 positive cases were detected by hysteroscopy,and the Kappa value of the examination results and pathological examination results was 0.751,which was in good agreement.The sensitivity,specificity and accuracy of ultrasound diagnosis of abnormal uterine bleeding in perimenopause were 82.26%,71.43%and 80.26%,respectively.The sensitivity,specificity and accuracy of hysteroscopy were 93.55%,85.71%and 92.11%,respectively.There was no significant difference in the etiological diagnosis of abnormal uterine bleeding caused by submucosal fibroids and endometrial polyps by hysteroscopy and ultrasound(P>0.05).The effect of hysteroscopy on the etiological diagnosis of endometrial hyperplasia was higher than that of ultrasound(P<0.05).Conclusion:Hysteroscopy can effectively diagnose abnormal uterine bleeding and its etiology in perimenopause,and has a high diagnostic coincidence rate.