综合评分诊断卵巢子宫内膜异位囊肿的临床研究  

The clinical research to diagnose ovarian endometrial cyst by comprehend evaluation

作　　者：刘俊丽[1] 赵轩[2] 李玉平[1] 

机构地区：[1]山西长治医学院附属和平医院妇产科,046000 [2]遵义医学院妇产科

出　　处：《肿瘤研究与临床》2007年第z1期-,共4页Cancer Research and Clinic

摘　　要：目的 探讨卵巢子宫内膜异位囊肿(巧克力囊肿)临床诊断标准.方法 对218例因附件包块住院治疗的患者,进行临床症状、体征、超声、血清CA125四项指标分析,通过临床综合评分进行诊断及分期(轻、中、重三型)再行腹腔镜手术并与术中诊断及分期相比较.其中经腹腔镜诊治及病理确诊为卵巢子宫内膜异位囊肿172例,经腹腔镜手术治疗的卵巢良性肿瘤及输卵管积液共46例.结果 临床评分法诊断卵巢子宫内膜异位囊肿,诊断敏感性96.4%;特异性79.6%;阳性预测值93.0%;阴性预测值90.0%,诊断符合率91.7%,诊断指数73.4%.与对照组比较差异有统计学意义(χ2=127.818,P＜0.001).临床综合评分法诊断卵巢子宫内膜异位囊肿分期的符合率,轻型与Ⅰ～Ⅱ期诊断符合率95.6%;中型与Ⅲ期诊断符合率95.6%;重型与Ⅳ期诊断符合率83.0%.轻型、中型间诊断符合率比较差异无统计学意义(χ2=0,P＞0.05);轻型、中型和重型间诊断符合率比较差异有统计学意义(χ2=4.472,P＜0.05).结论 临床综合评分法可试用于临床对卵巢子宫内膜异位囊肿的诊断及分期.Objective To explore the clinical diagnositic code(CDC)in ovarian endometrial cysts (OEC).Methods 218 cases of pelvic masses were investigated by use of symptoms,signs,B mode sonography and CA125.172 cases were diagnosed with OEC out of 218 cases,While 46 cases were ruled out by combination exploratory laparotomy and laparoscopy.Meanwhile we compared it with revisional american fertility society(r-AVS)including diagnosis and staging.Results The operation results of 218 cases were compared with the results of CDC and its Diagnositic Sensitiveness;Specificness;Positive predictive value;Negative predictive value;Diagnositic accordance rate as well as Diagnositic index of CDC were 96.4%,79.6%.93.0%,90.0%,91.7% and 73.4% respectively(χ2=127.818,P＜0.001).Further more,172 cases of OEC which diagnosed with CDC were further subdivided into three stages as 1,2,3 according to its score,mild;moderate;heavy and this stage category were compared with the category of AFS(Ⅰ-Ⅱ,Ⅲ,Ⅳ),the Diagnositic accordance rate of two categories were 95.6%,95.6% and 83.0% respectively,No significant difference were found in Var.mitis and medium-sized(χ2=0,P＞0.05).but the Medium-sized and Gravis tape was significance(χ2=4.472,P＜0.05).Conclusion CDC has a better coincidence with operation in the diagnosis of OEC which can be used in the non-traumatic diagnosis and staging of OEC in clinic.

关 键 词：卵巢囊肿 子宫内膜异位症 诊断 

分 类 号：R737.31[医药卫生—肿瘤]