探讨阴道超声与宫腔镜对绝经后子宫出血的诊断价值

To evaluate the diagnostic value of transvaginal ultrasonography and hysteroscopy in postmenopausal uterine bleeding

目的:探讨分析阴道超声与宫腔镜对绝经后子宫出血的临床诊断价值。方法:选择160例子宫出血患者作为研究对象,先后接受阴道超声检查、宫腔镜检查及病理学检查,比较检查结果及阴道超声、宫腔镜检查的敏感性与阳性预测值。结果:病理诊断结果显示阴道超声与宫腔镜均存在一定的阴性误差。在子宫内膜增殖症和内膜非特异性病变检查的诊断上,宫腔镜的敏感性显著高于阴道超声检查,且差异明显(P<0.05);在子宫内膜息肉、内膜非特异性病变、子宫粘膜下肌瘤、子宫内膜癌的诊断上,宫腔镜的阳性预测值显著高于阴道超声检查,且差异明显(P<0.05)。结论:阴道超声检查可作为绝经后子宫出血的初步筛查工具,宫腔镜具有更高的敏感性和阳性预测值,可作为进一步检查的手段。

Objective To investigate the clinical effect and value of transvaginal sonography and hysteroscopy in the diagnosis of uterine bleeding after menopause.Methods 160 cases of uterine bleeding patients as the research object,underwent transvaginal ultrasonography, hysteroscopy and pathological examination, examination results and comparison of the sensitivity of transvaginal ultrasound and hysteroscopy with positive predictive value.Results The pathological diagnosis showed that there were some negative errors between transvaginal ultrasound and hysteroscopy. The sensitivities of hysteroscopy on the diagnosis of endometrial nonspecipc lesions and endometrial hyperplasia were signigicantly higher than that of vaginal ultrasound(P < 0.05);The positive predictive value of hysteroscopy on the diagnosis of endometrial nonspecipc lesions, endometrial polyps, submucous myoma, endometrial cancer were sig nigicantly higher than that of vaginal ultrasound(P < 0.05). Conclusion Transvaginal ultrasonography could be used as a preliminary screening tool for postmenopausal uterine bleeding. Hysteroscopy had higher sensitivity and positive predictive value, and could be used as a means of further examination.