经阴道超声与宫腔镜对子宫内膜病变患者的诊断价值比较研究

目的:探讨经阴道超声与宫腔镜检查诊断子宫内膜病变的临床价值,为临床诊断子宫内膜病变提供理论依据。方法:选取2011年3月-2014年3月间我院收治的158例疑似子宫内膜病变患者,分别采用经阴道超声和宫腔镜进行检查,并以病理诊断结果为"金标准",比较两种检查方法的诊断价值。结果:病理检查结果中,143例患者被确诊为子宫内膜病变,其中子宫内膜增生23例(16.08%),子宫内膜息肉31例(21.68%),子宫粘膜下肌瘤24例(16.78%),子宫内膜癌19例(13.29%),慢性非特异性子宫内膜炎46例(32.17%)。宫腔镜对子宫内膜病变诊断的准确率为94.41%,高于阴道超声的81.12%,差异有统计学意义(P0.05),其中阴道超声和宫腔镜对子宫粘膜下肌瘤、子宫内膜癌诊断的准确率比较差异无统计学意义(P0.05),阴道超声对子宫内膜增生、子宫内膜息肉及慢性非特异性子宫内膜炎的诊断准确率均较宫腔镜降低,差异有统计学意义(P0.05)。阴道超声对子宫内膜病变诊断的特异度较宫腔镜更低(P0.05),但两者灵敏度、AUC比较差异无统计学意义(P0.05)。结论:经阴道超声诊断子宫内膜病变简单、有效,而宫腔镜诊断子宫内膜病变具有准确率以及特异度较高的特点。

Comparative Study of Transvaginal Ultrasonography and Hysteroscopy in Diagnosis of Endometrial Lesions

ABSTRACT Objective: To investigate the clinical value of transvaginal ultrasonography and hysteroscopy in the diagnosis of en- dometrial lesions, to provide a theoretical basis for the clinical diagnosis of endometrial lesions. Methods: A total of 158 cases of suspected endometrial lesions, who were treated in Beijing First Hospital of Integrated Chinese and Western Medicine from March 2011 to March 2014, were selected and were detected by transvaginal sonography and hysteroscopy respectively. The diagnostic value of the two meth- ods was compared with the results of pathological diagnosis as the gold standard. Results: In the results of pathological examination, 143 patients were diagnosed as endometrial lesions, including 23 cases of endometrial hyperplasia(16.08%), 31 cases of endometrial polyps(21.68%), 24 cases of uterine submucosal myoma(16.78%), 19 cases of endometrial carcinoma(13.29%), 46 cases of chronic nonspecific endometritis(32.17%). The accuracy rate(94.41%) of hysteroscopy in the diagnosis of endometrial lesions was higher than that(81.12%) of transvaginal ultrasound, and the difference was significant (P<0.05); there were no statistical differences in the accuracy rate of the di- agnosis of submucosal myoma of uterus and endometrial carcinoma between transvaginal ultrasonography and hysteroscopy(P>0.05), and the accuracy rate of transvaginal ultrasound in endometrial hyperplasia, endometrial polyps and chronic nonspecific endometritis was lower than that of hysteroscopy, and the difference was statistically significant (P<0.05). The specificity of transvaginal ultrasonography in the diagnosis of endometrial lesions was lower than that of hysteroscopy (P<0.05), but there were no significant differences in sensitivity and AUC between the two methods (P>0.05). Conclusion: Transvaginal ultrasonography is a simple and effective method in diagnosis of endometrial diseases, and Hysteroscopy has higher accuracy and higher specificity in diagnosis of endometrial diseases.