| 鞠蕊,焦阳,刘晓刚,等.经阴道超声与宫腔镜在绝经后子宫内膜病变诊断中的价值比较[J].安徽医药,2020,24(8):1545-1548. |
| 经阴道超声与宫腔镜在绝经后子宫内膜病变诊断中的价值比较 |
| Comparison of the diagnosis of endometrial lesions in postmenopausal women by transvaginal ultrasonography and hysteroscopy |
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| DOI：10.3969/j.issn.1009?6469.2020.08.016 |
| 中文关键词: 子宫疾病 绝经后期 腔内超声检查 宫腔镜检查 病理过程 子宫内膜 敏感性 特异性 |
| 英文关键词: Uterine diseases Postmenopause Endosonography Hysteroscopy Pathologic processes Endometrium Sensitivity Specificity |
| 基金项目:北京市朝阳区科技计划项目(CYSF1713) |
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| 中文摘要: |
| 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(χ2＝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(χ2＝23.715、χ2＝5.128、χ2＝10.815，均 P＜0.05)。结论 TVS检查重复性好、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有可，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。 |
| 英文摘要: |
| Objective To compare the values of the diagnosis of endometrial diseases in postmenopausal women by transvaginal ul? trasonography(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 De? cember 2017，were selected and underwent TVS and hysteroscopy.Pathological examination findings were used as the diagnostic cri? teria，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(χ2＝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 val? ue 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(χ2＝23.715，χ2＝5.128，χ2＝10.815，respectively；all P＜0.05).Conclusions 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 postmeno?pausal endometrial lesions.Hysteroscopy has the advantages of accurate positioning and higher diagnostic accuracy，and when pa? tients have continuous vaginal bleeding or endometrial abnormalities，hysteroscopy should be the first choice for diagnosis. |
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