阴道超声联合宫腔镜诊治围绝经期妇女子宫内膜病变的临床价值  

Clinical value of transvaginal ultrasonography combined with hysteroscopy in the diagnosis and treatment of perimenopausal women with endometrial lesions

作　　者：李莹莹[1] 程玲慧[1] 宋汝丹 崔欠欠 李泽莲[1] 韦雯雯[1] Li Yingying;Cheng Linghui;Song Rudan;Cui Qianqian;Li Zelian;Wei Wenwen(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院妇产科,合肥230022

出　　处：《中国临床保健杂志》2018年第2期246-250,共5页Chinese Journal of Clinical Healthcare

基　　金：安徽省年度科研计划基金项目(10021303020)

摘　　要：目的探究子宫内膜厚度与组织病理学诊断之间的关系,以及经阴道超声(TVS)联合宫腔镜检查(HS)对围绝经期妇女子宫内膜病变的临床应用价值。方法选取因异常子宫出血收治的围绝经期女性共130例。所有入选者均行经阴道超声检查,后行宫腔镜直视下检查行分段诊刮,送检刮出的组织,做病理学诊断。结果筛查子宫内膜病变的最佳内膜厚度的截止值为5.5 mm,其对应的灵敏度、特异度、约登指数、阳性预测值、阴性预测值分别是95.24%、51.38%、46.62%、27.40%、98.20%,HS对子宫内膜病变的灵敏度、特异度、阳性预测值、阴性预测值、符合率分别为96.26%,特异度86.96%,阳性预测值97.17%,阴性预测值83.33%,其中,对于子宫内膜非典型增生和子宫内膜癌的符合率分别为97.69%、99.23%。结论 TVS测量的子宫内膜厚度对子宫内膜病变是具有初筛作用的敏感方法,可在此基础上指导实施组织病理学检查鉴别内膜的性质。HS对诊断子宫内膜良恶性病变具有较高的符合率,可提高准确率。Objective To explore the relationship between endometrial thickness and histopathological diagnosis,and the clinical value of transvaginal ultrasound(TVS)combined with hysteroscopy(HS)on endometrial lesions of perimenopausal women.Methods One hundred and thirty cases of perimenopausal women were admitted due to abnormal uterine bleeding.All subjects were underwent transvaginal ultrasonography,hysteroscopy under the line under the inspection line segmented curettage,and do pathological diagnosis.Results The best cutoff value of endometrial thickness was 5.5 mm,and the corresponding sensitivity,specificity,Jordan index,positive predictive value and negative predictive value were 95.24%,51.38%,46.62%,27.40%,98.20%respectively.,The sensitivity,specificity,positive predictive value and negative predictive value of HS on endometrial lesions were 96.26%,86.96%,97.17%and 83.33%respectively,The coincidence rate of endometrial atypical hyperplasia and endometrial cancer were 97.69%,99.23%respectively.Conclusion TVS has a screening effect for endometrial lesions by measured endometrial thickness.HS has a high coincidence rate in the diagnosis of benign and malignant endometrial lesions,which can improve the accuracy.

关 键 词：子宫疾病 围绝经期 超声检查 多普勒 彩色 宫腔镜检查 

分 类 号：R711.74[医药卫生—妇产科学]