摘要
目的探讨经阴道超声联合宫腔镜检查在绝经后宫腔积液病因诊断中的价值,为临床提供参考。方法选择2013年12月-2016年12月在重庆市人民医院就诊的73例绝经后宫腔积液患者作为研究对象,在征得患者知情同意下进行经阴道超声检查、宫腔镜检查以及经阴道超声联合宫腔镜检查并以病理学结果为参照,对3种检查结果进行比较。结果病理学结果证实,73例绝经后宫腔积液患者中子宫内膜炎13例、萎缩性子宫内膜15例、子宫内膜增生19例(12例单纯性子宫内膜增生、7例不典型子宫内膜增生)、子宫内膜息肉8例、黏膜下肌瘤9例、子宫内膜癌9例,宫腔镜检查符合率为92.31%、85.71%、89.47%、100.00%、100.00%、100.00%,经阴道超声检查符合率为84.62%、85.71%、89.47%、87.50%、88.88%、100.00%,经阴道超声联合宫腔镜检查符合率为100.00%、93.33%、94.74%、100.00%、100.00%、100.00%,组间比较差异无统计学意义(P>0.05);经阴道超声联合宫腔镜检查敏感度96.88%、特异度100.00%、准确度97.26%,宫腔镜检查敏感度85.94%、特异度100.00%、准确度87.67%,经阴道超声检查敏感度90.63%、特异度100.00%、准确度90.41%,三者相比较,差异无统计学意义(P>0.05)。结论在绝经后宫腔积液病因诊断中经阴道超声联合宫腔镜检查能够有效提高诊断准确率。
Objective To explore the value of transvaginal ultrasonography combined with hysteroscopy in etiological diagnosis of postmenopausal uterine cavity effusion,provide reference for clinical treatment. Methods From December 2013 to December 2016,73 patients with postmenopausal uterine cavity effusion treated in Chongqing People＇s Hospital were selected as study object,based on principle of informed consent,transvaginal ultrasonography,hysteroscopy,and transvaginal ultrasonography combined with hysteroscopy were performed,pathological result was obtained as gold standard. The results of three examination methods were compared. Results Pathological examination showed that there were 13 patients with endometritis,15 patients with atrophic endometrium,19 patients with endometrial hyperplasia（ 12 patients with simple hyperplasia of endometrium,7 patients with atypical endometrial hyperplasia）,8 patients with endometrial polyp,9 patients with submucous myoma,and 9 patients with endometrial cancer. The coincidence rates of hysteroscopy were 92. 31%,85. 71%,89. 47%,100. 00%,100. 00%, and 100. 00%, respectively; the coincidence rates of transvaginal ultrasonography were 84. 62%,85. 71%,89. 47%,87. 50%,88. 88%,and 100. 00%,respectively; the coincidence rates of transvaginal ultrasonography combined with hysteroscopy were 100. 00%,93. 33%,94. 74%,100. 00%,100. 00%,and 100. 00%,respectively; there was no statistically significant difference among the three groups（ P〉0. 05）. The sensitivity,specificity,and accuracy of transvaginal ultrasonography combined with hysteroscopy were 96. 88%,100. 00%,and 97. 26%,respectively; the sensitivity,specificity,and accuracy of hysteroscopy were 85. 94%,100. 00%,and 87. 67%,respectively; the sensitivity,specificity,and accuracy of transvaginal ultrasonography were 90. 63%,100. 00%,and 90. 41%,respectively; there was no statistically significant difference among the three groups（ P〉0. 05）. Conclusion Transvaginal ultrasonography combined with hysteroscopy can effectively improve the accurate rate of etiological diagnosis of postmenopausal uterine cavity effusion.
作者
张婵
冉光琴
ZHANG Chan;RAN Guang-Qin(Department of Gynecology and Obstetrics,Chongqing Angel Obstetrics and Gynecology Hospital,Chongqing,401147,China)
出处
《中国妇幼保健》
CAS
2018年第16期3740-3742,共3页
Maternal and Child Health Care of China
关键词
经阴道超声
宫腔镜
绝经后
宫腔积液
病因诊断
Transvaginal uhrasonography
Hysteroscopy
Postmenopause
Uterine cavity effusion
Etiological diagnosis
