经阴道彩色多普勒超声检查诊断不规则阴道出血的临床应用  

Clinical application of transvaginal color Doppler ultasound examinationed irregular vaginal bleeding

作　　者：宋兆琼 赖小今[2] 梁燕[2] 江雪清[1] 朱陈[1] 邓琪[1] 

机构地区：[1]资阳市第一人民医院超声科,四川资阳641300 [2]成都军区总医院超声科,四川成都610083

出　　处：《四川医学》2013年第2期299-300,共2页Sichuan Medical Journal

摘　　要：目的分析经阴道彩色多普勒超声检查诊断不规则阴道出血的临床应用价值。方法对120例不规则阴道出血的患者行阴道彩色多普勒超声检查,观察内膜厚度、内膜血流,并与手术和内膜诊刮病理对照。结果 120例患者中,手术、病理和临床发现阳性病变115例,未见病变5例。诊断异位妊娠19例,子宫肌瘤9例,急性附件炎6例,子宫内膜病变81例(其中子宫内膜癌23例,内膜增生31例,子宫内膜炎10例、内膜息肉17例)。超声发现阳性病变109例,未发现异常病变11例。超声诊断宫外孕17例,子宫肌瘤9例,卵巢肿瘤2例,附件炎状肿大6例,子宫内膜病变75例(内膜癌26例,内膜增生29例,子宫内膜炎6例、内膜息肉14例)。超声与临床诊断不符11例。漏诊6例,(子宫内膜炎1例,内膜增生2例,内膜息肉3例)。误诊5例(宫外孕2例误诊为卵巢肿瘤,3例子宫内膜炎误诊为子宫内膜癌)。阴道不规则流血疾病的临床阳性诊断率为95.83%(115/120)。超声阳性诊断率为90.83%(109/120)。超声诊断符合率为94.78%(109/115)。结论经阴道彩超检查诊断不规则阴道出血有重要价值,对疾病的检出率较高,可以发现子宫内外疾病并对子宫内膜良、恶性病变有重要诊断价值。Objective To analysis the clinical application value of transvaginal color Doppler ultrasound in examination irregular vaginal bleeding.Methods 120 cases of irregular vaginal bleeding underwented transvaginal color Doppler ultrasonography,observe endometrial thickness,endometrial blood flow,and were compared with operation and endometrial curettage pathology.Results Operation、pathology and clinical found positive lesions in 115 cases,no lesions in 5 cases.Diagnosis of 19 cases of ectopic pregnancy,9 cases of uterine leiomyomas,6 cases of acute inflammation,endometrial lesions in 81 cases（including 23 cases of endometrial carcinoma,endometrial hyperplasia in 31 cases,10 cases of endometrial polyps endometritis,report of 17 cases）.Ultrasound findings of positive lesions in 109 cases,no abnormal lesion in 11 cases.Ultrasonic diagnosis of ectopic pregnancy in 17 cases,9 cases of uterine leiomyomas,2 cases of ovarian tumor,annex inflammation,swelling in 6 cases,endometrial lesions in 75 cases（26 cases of endometrial carcinoma,endometrial hyperplasia in 29 cases,6 cases of endometrial polyps endometritis,report of 14 cases）.Ultrasonography and clinical diagnostic discrepancies in 11 cases.Misdiagnosis of 6 cases（1 cases,endometritis,intimal hyperplasia in 2 cases,endometrial polyps： a report of 3 cases）.Misdiagnosis of 5 cases（2 cases of ectopic pregnancy misdiagnosed as ovarian tumor,3 cases were misdiagnosed as carcinoma of the endometrium endometritis）.Irregular vaginal bleeding disease clinical diagnostic rate was 95.83%（115 / 120）.Ultrasound diagnostic rate was 90.83%（109 / 120）.Ultrasound diagnostic coincidence rate was 94.78%（109 / 115）.Conclusion Transvaginal color doppler ultrasound examination in the diagnosis of irregular vaginal bleeding has important value to the disease,a higher detection rate,can be found inside and outside the uterus disease and endometrial benign,malignant lesions has important diagnostic value.

关 键 词：不规则阴道出血 经阴道彩色多普勒超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]