宫腔镜检查用于围绝经期女性异常阴道出血的临床价值  

Clinical value of hysteroscopy in abnormal vaginal bleeding in perimenopausal women

作　　者：吴秀琼 WU Xiuqiong(Department of Gynecology and Obstetrics,Chengxiang District Hospital of Putian City,Fujian Province,Putian351100,China)

机构地区：[1]福建省莆田市城厢区医院妇产科,莆田福建351100

出　　处：《中国当代医药》2022年第29期101-104,共4页China Modern Medicine

摘　　要：目的分析宫腔镜检查对围绝经期女性异常阴道出血的诊断价值。方法选取2020年1月至2021年12月就诊于福建省莆田市城厢区医院妇产科的313例围绝经期出血患者作为研究对象,所有患者均行阴道B超和宫腔镜检查,以病理学检查为金标准,比较不同方式对不同病因异常阴道出血的检出率,另比较不同方式对疾病的诊断效能。结果病理检查结果显示,313例围绝经期女性中,253例为子宫内膜病变患者,60例为子宫内膜正常者;子宫内膜病变患者中90例为子宫内膜增生,67例为子宫内膜息肉,45例为子宫内膜炎,27例为子宫内膜下肌瘤,24例为子宫内膜癌。宫腔镜对异常阴道出血病因的诊断符合率为96.84%,高于阴道B超的83.40%,差异有统计学意义(P<0.05);宫腔镜诊断异常子宫出血的敏感性为96.84%,特异性为90.00%,准确性为95.53%,阳性预测值为97.61%,阴性预测值为87.10%,高于阴道B超的83.40%、75.00%、81.79%、93.36%和51.72%,差异有统计学意义(P<0.05)。结论宫腔镜检查可准确围绝经期女性异常阴道出血,明确出血病因,为疾病治疗工作的开展提供依据,存在推广价值。Objective To analyze the diagnostic value of hysteroscopy for abnormal vaginal bleeding in perimenopausal women.Methods A total of 313 patients with perimenopausal bleeding who were treated in the Department of Gynecology and Obstetrics,Chengxiang District Hospital of Putian City,Fujian Province from January 2020 to December 2021 were selected as the research objects.All patients underwent vaginal B-ultrasound and hysteroscopy.The gold standard is to compare the detection rates of different methods for abnormal vaginal bleeding with different etiologies,and to compare the diagnostic efficacy of different methods.Results The results of pathological examination showed that among the 313 perimenopausal women,253 were endometrial lesions,60 were endometrial normal.90 were endometrial hyperplasia,67 were endometrial polyps,45 were endometrial polyps,27 were subendometrial fibroids,and 24 were endometrial carcinomas in endometrial lesions patients.The coincidence rate of hysteroscopy in the diagnosis of abnormal vaginal bleeding was 96.84%,which was higher than 83.40%of vaginal ultrasound,and the difference was statistically significant(P<0.05).The sensitivity of hysteroscopy in the diagnosis of abnormal uterine bleeding was 96.84%,the specificity was 90.00%,the accuracy was 95.53%,the positive predictive value was 97.61%and the negative predictive value was 87.10%,which were higher than 83.40%,75.00%,81.79%,93.36%and 51.72%of vaginal B-ultrasound,and the differences were statistically significant(P<0.05).Conclusion Hysteroscopy can accurately detect abnormal vaginal bleeding in perimenopausal women,identify the cause of bleeding,and provide a basis for the development of disease treatment,which has promotion value.

关 键 词：宫腔镜检查 围绝经期女性 异常阴道出血 符合率 诊断效能 

分 类 号：R711.52[医药卫生—妇产科学]