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目的探讨宫腔镜、B超在诊断异常子宫出血中的应用价值。方法回顾分析2001年4月至2004年9月初诊为异常子宫出血并进行了B超、电子宫腔镜检查的86例病例。结果B超报告子宫内膜正常者42例,宫腔镜诊断宫内膜息肉2例、增殖期子宫内膜4例、宫颈管小息肉2例,病理报告与宫腔镜诊断相符。B超发现异常情况44例,经宫腔镜检查活检、诊刮的病理报告异常的有32例,宫腔镜对诊断宫内膜息肉、子宫肌瘤、宫内膜癌的准确性较高分别达100%、8333%、100%,宫腔镜诊断宫内膜增生、宫内膜萎缩的准确性分别达619%、50%。宫腔镜诊断子宫异常出血的漏诊率为0,腹部结合阴道B超检查的敏感性为906%,漏诊率93%。结论宫腔镜检查只有结合B超并与定位组织活检、诊刮相结合,才能提高对宫腔内疾病诊断的准确性。
Objective To investigate the value of hysteroscopy and B-ultrasonography in the diagnosis of abnormal uterine bleeding. Methods A retrospective analysis of April 2001 to September 2004 first diagnosed as abnormal uterine bleeding and B ultrasound, electronic hysteroscopy in 86 cases. Results 42 cases of normal endometrial B-report, 2 cases of endometrial polyps diagnosed by hysteroscopy, 4 cases of proliferative endometrium, 2 cases of cervical polyp, the pathological report was consistent with hysteroscopy. B-ultrasound found abnormalities in 44 cases, the hysteroscopy biopsy, curettage pathological reports were abnormal in 32 cases, hysteroscopy for the diagnosis of endometrial polyps, uterine fibroids, endometrial cancer higher accuracy Up to 100%, 8333%, 100%, hysteroscopy diagnosis of endometrial hyperplasia, endometrial atrophy accuracy respectively 619%, 50%. The misdiagnosis rate of hysteroscopy in diagnosing abnormal uterine bleeding was 0, the sensitivity of abdominal combined vaginal B-ultrasound was 906% and the rate of misdiagnosis was 93%. Conclusion Hysteroscopy only combined with B-and biopsy and curettage combined to improve the diagnostic accuracy of intrauterine diseases.