宫腔镜、超声在子宫内膜病变的诊断价值对比及临床意义探讨  

Clinical Significance of Hysteroscopy and Ultrasonography in Diagnosis of Endometrial Lesions

作　　者：黄宇[1] 杨年[1] 付奇[1] 

机构地区：[1]四川省人民医院城东病区妇产科,成都610041

出　　处：《南昌大学学报（医学版）》2014年第3期32-36,共5页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨宫腔镜、超声检查在子宫内膜病变中的诊断价值及临床意义。方法对186例疑似子宫内膜病变患者行宫腔镜和超声检查,并进行刮宫或活检,将检查结果与病理学诊断对照分析。结果宫腔镜检查诊断为子宫内膜病变167例中,病理学诊断为子宫内膜病变165例,正常者2例;宫腔镜检查未发生子宫内膜病变19例中,病理学诊断未发生子宫内膜病变14例,发生子宫内膜病变5例。超声检查诊断为子宫内膜病变166例中,病理学诊断子宫内膜病变为159例,正常者7例;超声检查未发生子宫内膜病变20例中,病理学诊断未发生子宫内膜病变9例,发生子宫内膜病变11例。病理学诊断为金标准,宫腔镜和超声诊断子宫内膜病变的符合率比较,在内膜增生、黏膜下肌瘤、内膜息肉、内膜癌、内膜萎缩方面差异无统计学意义(均P>0.05);在慢性非特异性子宫内膜炎方面差异有统计学意义(P<0.01)。结论宫腔镜检查是可靠的诊断方法,超声检查是有效、简便、经济的方法,病理学诊断为确诊方法,联合检查是最佳的检查方法。Objective To explore the clinical significance of hysteroscopy and ultrasonography in the diagnosis of endometrial lesions.Methods A total of 186 patients with suspected endome-trial lesions underwent hysteroscopy,ultrasonography and curettage or biopsy.The results of hys-teroscopy and ultrasonography were compared with pathological results.Results Among the 167 patients with endometrial lesions diagnosed by hysteroscopy,pathological diagnosis showed le-sions in 165 and normality in 2.Among the 19 patients without hysteroscopy-confirmed endome-trial lesions,pathological diagnosis showed lesions in 5 and normality in 14.Among the 166 pa-tients with endometrial lesions diagnosed by ultrasonography,pathological diagnosis showed le-sions in 159 and normality in 7.Among the 20 patients without ultrasonography-confirmed endo-metrial lesions,pathological diagnosis showed lesions in 11 and normality in 9.Using the patho-logical diagnosis as the gold standard,the difference was significant between hysteroscopy and ul-trasonography in coincidence rate for the diagnosis of chronic nonspecific endometritis （P 〈0.01）,but not for the diagnosis of intimal hyperplasia,submucosal fibroids,endometrial polyps, endometrial cancer and endometrial atrophy （P 〈0.05）.Conclusion Hysteroscopy is a reliable diagnostic method.Ultrasonography is an effective,simple and economical diagnostic method.Pa-thology is the definite diagnosis.The combined hysteroscopy,ultrasonography and pathology de-tection is the optimal method for the diagnosis of endometrial lesions.

关 键 词：宫腔镜 超声 子宫内膜病变 

分 类 号：R616.5[医药卫生—外科学] R445.1[医药卫生—临床医学]