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目的:探讨宫腔镜检查与阴道彩色超声(TVB)对宫内占位性疾病的诊治价值。方法:回顾性分析因不孕、绝经后出血、阴道彩色超声提示宫腔占位等不同原因行宫腔镜检查的1 065例患者,根据宫腔镜检查结果,了解TVB诊断的准确率及宫腔占位性疾病的病理性质。结果:1 065例宫腔镜检查的患者术前TVB提示有宫内占位的为800例,经宫腔镜检查,术中见宫内占位900例,2种检查方法相比,差异无统计学意义(P>0.05)。术前TVB提示有宫内占位的800例患者中,经宫腔镜检查证实有宫内占位750例,TVB与宫腔镜检查的阳性符合率为93.8%(750/800),假阳性率为6.2%(50/800)。术前TVB未提示宫内占位的265例患者中,经宫腔镜检查存在宫内占位的有150例,TVB的假阴性率为10.8%(115/1 065)。宫腔镜术后病理诊断提示,宫腔内膜息肉670例,占62.9%(670/1 065),子宫黏膜下肌瘤121例,占11.4%(121/1065),内膜简单性增生153例,占14.4%(153/1 065),内膜功能性增生93例,占8.7%(93/1 065),复杂性增生9例,占0.8%(9/1 065),不典型增生8例,占0.8%(8/1 065),子宫内膜癌11例,占1.0%(11/1 065)。结论:准确诊断宫内占位性疾病性质,须在宫腔镜直视下检查并取材进行病理诊断,此是宫内占位性疾病的最终诊断结果。
Objective: To investigate the value of hysteroscopy and vaginal color ultrasound (TVB) in the diagnosis and treatment of intrauterine occupying diseases. Methods: A retrospective analysis of 1 065 patients undergoing hysteroscopy due to different causes of infertility, postmenopausal bleeding and vaginal color ultrasound prompted hysteroscopy. According to the results of hysteroscopy, the diagnostic accuracy of TVB and the uterine cavity Pathological features of occupying diseases. Results: 1 065 cases of hysteroscopy in patients with preoperative TVB tips intrauterine occupancy of 800 cases, the hysteroscopy, intraoperative intrauterine occupancy, see 900 cases, the two methods of examination, the difference was Statistical significance (P> 0.05). Preoperative TVB tips intrauterine mass in 800 patients, confirmed by hysteroscopy intrauterine occupancy in 750 cases, TVB and hysteroscopy positive coincidence rate of 93.8% (750/800), false positive The rate was 6.2% (50/800). Among the 265 patients who did not show intrauterine occupancy in preoperative TVB, there were 150 cases of intrauterine occupancy by hysteroscopy, and the false negative rate of TVB was 10.8% (115/1 065). Pathological diagnosis of hysteroscopy prompted endometrial polyps in 670 cases, accounting for 62.9% (670/1 065), uterine fibroids in 121 cases, accounting for 11.4% (121/1065), intimal hyperplasia 153 Cases accounted for 14.4% (153/1 065), endometrial hyperplasia 93 cases (8.7%), complicated hyperplasia 9 cases (0.8%), dysplasia 8 Cases, accounting for 0.8% (8/1 065), 11 cases of endometrial cancer, accounting for 1.0% (11/1 065). Conclusion: Accurate diagnosis of intrauterine occupying diseases should be examined under hysteroscopy and taken for pathological diagnosis. This is the final diagnosis of intrauterine occupying diseases.