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目的:探究阴道超声与宫腔镜对诊断子宫内膜病变的临床应用价值。方法:选取我院妇产科收治的子宫内膜病变患者153例,进行阴道超声及宫腔镜检测,观测患者病变类型以及病变部位,比较术后患者临床资料与术前阴道超声以及宫腔镜的检测结果,对阴道超声及宫腔镜的准确率、敏感性、阳性预测率以及阴性预测率等进行比较。结果:阴道超声检测内膜增生漏诊3例、内膜息肉误诊3例、粘膜下肌瘤误诊2例、内膜炎漏诊2例、内膜癌漏诊1例;宫腔镜检测内膜息肉误诊1例、黏膜下肌层误诊2例、内膜炎漏诊1例;与病理活检结果的符合率比较,宫腔镜的总符合率显著高于阴道超声,差异有统计学意义(P<0.05)。宫腔镜检测子宫内膜病变的准确率、敏感性、阳性预测率及阴性预测率显著优于阴道超声,差异有统计学意义(P<0.05)。结论:阴道超声和宫腔镜均可检测子宫内膜病变,前者操作简单、创伤小,后者操作复杂,但检出率、准确率及敏感度均较高,可减少临床误诊、漏诊的发生率。
Objective: To explore the clinical value of vaginal ultrasound and hysteroscopy in the diagnosis of endometrial lesions. Methods: A total of 153 cases of endometrial lesions treated by obstetrics and gynecology in our hospital were selected for vaginal ultrasonography and hysteroscopy. The types of lesions and lesions were observed. The clinical data, postoperative vaginal ultrasound and hysteroscopy Of the test results, the accuracy of vaginal ultrasound and hysteroscopy, sensitivity, positive predictive rate and negative predictive rate were compared. Results: 3 cases of missed diagnosis of endometrial hyperplasia, 3 cases of misdiagnosis of endometrial polyps, 2 cases of misdiagnosis of submucous myoma, 2 cases of endometritis misdiagnosis, 1 case of endometrial misdiagnosis, 1 case of endometrial polyp misdiagnosis Cases, submucous muscle misdiagnosis in 2 cases, 1 case of endometritis missed; consistent with the biopsy results, the total coincidence rate of hysteroscopy was significantly higher than that of vaginal ultrasound, the difference was statistically significant (P <0.05). The accuracy, sensitivity, positive predictive rate and negative predictive value of hysteroscopy in detecting endometrial lesions were significantly better than those of vaginal ultrasound (P <0.05). Conclusion: Vaginal ultrasound and hysteroscopy can both detect endometrial lesions. The former is simple and the trauma is small. The latter is complicated to operate, but the detection rate, accuracy and sensitivity are high, which can reduce the occurrence of misdiagnosis and missed diagnosis. rate.