摘要
目的比较经阴道超声(TVS)检查与宫腔镜(HS)检查在绝经后子宫内膜病变诊断中的价值。方法选取北京市垂杨柳医院2015年1月至2017年12月收治的绝经后有阴道出血或者阴道超声提示子宫内膜异常的病人355例,分别进行TVS诊断及HS诊断,以病理检查为诊断标准,对比两种检查方式的诊断结果。结果经TVS检查子宫内膜厚度>10 mm的病人与子宫内膜厚度<10 mm的病人比较,子宫内膜癌的发生率(13.01%及1.72%)明显升高,差异有统计学意义(χ~2=9.252,P<0.01)。阴道超声检查与病理诊断的符合率是74.65%,其中TVS检查敏感度、特异度、阳性预测值及阴性预测值分别是81.67%、29.81%、73.45%及40.25%。HS与病理诊断的符合率是96.61%,HS的敏感度、特异度、阳性预测值及阴性预测值分别是96.41%、97.12%、98.78%及91.82%。TVS与HS结果比较,两者敏感度差异无统计学意义(P>0.05),特异度、阳性预测值及阴性预测值均差异有统计学意义(χ~2=23.715、χ~2=5.128、χ~2=10.815,均P<0.05)。结论 TVS检查有可重复性好、操作简便、无创的优点,具有很好的敏感度,可作为绝经期子宫内膜病变常规筛查方法。当病人持续出现超声异常或阴道出血症状时,HS在诊断上有着定位准确以及诊断准确率更高的优点,应作为首选检查方法。
Objective To compare the values of the diagnosis of endometrial diseases in postmenopausal women by transvaginal ultrasonography(TVS)and hysteroscopy.Methods From Jan.2015 to Dec 2017,A total of 355 postmenopausal patients with vaginal bleeding or endometrial abnormalities detected by TVS,who were treated in Beijing Chuiyangliu Hospital from January 2015 to December 2017,were selected and underwent TVS and hysteroscopy.Pathological examination findings were used as the diagnostic criteria,and the diagnosis results of the two inspection methods were compared.Results Patients with endometrial thickness>10 mm detected by TVS had a significantly higher incidence rate of endometrial cancer than patients with endometrial thickness<10 mm(13.01% vs.1.72%),which showed a significant difference(χ~2=9.252,P<0.01).The coincidence rate of diagnosis between TVS and pathological diagnosis was 74.65%.Among them,the sensitivity,specificity,positive predicted value and negative predicted value of TVS were 81.67%,29.81%,73.45% and 40.25%,respectively.The coincidence rate of diagnosis between hysteroscopy and pathological diagnosis was 96.61%.The sensitivity,specificity,positive predicted value and negative predicted value of hysteroscopy were 96.41%,97.12%,98.78% and 91.82%,respectively.There was no significant difference in sensitivity between TVS and HS(P>0.05).There were significant differences in specificity,positive predicted value and negative predicted value between TVS and HS(χ~2=23.715,χ~2=5.128,χ~2=10.815,respectively;all P<0.05).Conclusion s TVS has the advantages of good repeatability,easy operation and noninvasive techniques,which has good sensitivity and can be used as a routine screening method for postmenopausal endometrial lesions.Hysteroscopy has the advantages of accurate positioning and higher diagnostic accuracy,and when patients have continuous vaginal bleeding or endometrial abnormalities,hysteroscopy should be the first choice for diagnosis.
作者
鞠蕊
焦阳
刘晓刚
赵桂君
汪红英
张苗苗
王燕
张宇
王敬
苏光
JU Rui;JIAO Yang;LIU Xiaogang;ZHAO Guijun;WANG Hongying;ZHANG Miaomiao;WANG Yan;ZHANG Yu;WANG Jing;SU Guang(Department of Obstetrics and Gynecology,Beijing Chuiyangliu Hospital,Beijing 100022,China;Department of Pathology,Beijing Chuiyangliu Hospital,Beijing 100022,China)
出处
《安徽医药》
CAS
2020年第8期1545-1548,共4页
Anhui Medical and Pharmaceutical Journal
基金
北京市朝阳区科技计划项目(CYSF1713)。
