摘要
目的 观察宫腔镜联合经阴道超声对不同病因异常子宫出血(AUB)的诊断价值.方法 选择2017年9月至2019年9月在诸暨市人民医院就诊的异常子宫出血患者260例为研究对象,患者最后均有组织病理检查结果,以此结果为金标准,同时进行宫腔镜检查、经阴道超声检查及两者联合检查,比较各检查方法对于不同病因异常子宫出血的鉴别诊断价值.结果 宫腔镜联合经阴道超声检查对不同病因AUB总体诊断符合率(96.54%)显著高于单独宫腔镜检查(84.60%)和单独经阴道超声检查(70.77%)(x2=21.653、63.131,P=0.000、0.000);而漏检率和误诊率(2.69%、0.77%)显著低于宫腔镜检查(10.38%,5.00%)和经阴道超声单独检查(19.32%、10.00%),差异均有统计学意义(x2=12.588、8.306、36.432、21.742,P=0.000、0.004、0.000、0.000);联合检查对于器质性AUB的诊断灵敏度和准确度(97.00%,96.54%)显著高于宫腔镜(88.41%,87.31%)和经阴道超声单独检查(78.54%,76.54%),且联合检查对器质性AUB的诊断特异性(92.59%)显著高于经阴道超声检查(59.26%),差异均有统计学意义(x2 =12.691、14.919、36.959、44.637、8.206,P=0.000、0.000、0.000、0.000、0.004).结论 宫腔镜联合经阴道超声检查可提高异常子宫出血病因鉴别诊断价值.
Objective To observe the clinical value of hysteroscopy combined with transvaginal ultrasound in the differential diagnosis of different causes of abnormal uterine bleding(AUB).Methods From September 2017 to.September 2019,260 patients with AUB who were treated in Zhuji People's Hospital were selected in the study.All patients had histopathological examination resuls,which was the gold standard.At the same time,hysteroscopy,transvaginal ultrasound and the combined detection were performed.The diagnostic value of each test method for different etiology of AUB was compared.Results The coincidence rate of hysteroscopy combined with transvaginal ultrasound(96.54%)in the overall identifieation of AUB of different causes was significantly higher than that of hysteroscopy(84.6%)and transvaginal ultrasound(70.77%)(χ2=21.653,63.131;P=0.000,0.000);while the.missed detection rate and misdiagnosis rate(2.69%,0.77%)were significantly lower than those of hysteroscopy(10.38%,5.00%)and transvaginal ulrasound(19.32%,10.00%)(χ2=12.588,8.306,36.432,21.742;P=0.000,0.004,0.000,0.000).The diagnostie sensitivity and aceuracy of combined detection for organie AUB(97.00%,96.54%)were significantly higher than those of hysteroscopy(88.41%,87.31%)and transvaginal ultrasound alone(78.54%,76.54%),and the diagnostic speeifcity of combined detection for organic AUB(92.59%)was significantly higher than that of transvaginal ultrasound(59.26%),the differences were statistically signifcant(χ2=12.691,14.919,36.959,44.637,8.206;P=0.000.0.000,0.000,0.000,0.004).Conclusion Hysteroscopy combined with transvaginal ultrasound can improve the fficieney of differential diagnosis of AUB.
作者
方蕾
周晓文
许旭东
Fang Lei;Zhou Xiaowen;Xu Xudong(Department of Ultrasound,Zhuji Peoples Hospital,Zhuji,Zhejiang 311800,China)
出处
《中国基层医药》
CAS
2020年第20期2482-2486,共5页
Chinese Journal of Primary Medicine and Pharmacy
