宫腔镜联合经阴道超声对围绝经期异常子宫出血及病因的临床诊断价值  

Clinical diagnostic value of hysteroscopy combined with transvaginal sonography for abnormal uterine bleeding and its etiology in perimenopause

作　　者：刘莉 LIU Li(Gynecology Department,Jiawang District People's Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市贾汪区人民医院妇科,221000

出　　处：《中国现代药物应用》2025年第7期78-81,共4页Chinese Journal of Modern Drug Application

摘　　要：目的分析宫腔镜(HS)联合经阴道超声(TVS)对围绝经期异常子宫出血的临床诊断价值。方法60例围绝经期异常子宫出血患者均行HS及TVS检查,以病理结果为“金标准”,比较HS、TVS单一检查以及联合检查的诊断符合率,并分析其诊断效能。结果病理诊断结果显示,黏膜下肌瘤、内膜增生、不典型增生、内膜息肉、内膜癌例数分别为15、18、7、16、4例。HS诊断符合率(88.33%)高于TVS(73.33%),联合检查诊断符合率(98.33%)高于HS、TVS单一检查(P<0.05)。受试者工作特征曲线(ROC曲线)分析结果显示,HS、TVS单一检查及联合检查诊断黏膜下肌瘤的曲线下面积(AUC)分别为0.834、0.781、0.961,敏感度分别为82.45%、80.24%、92.70%,特异度分别为76.42%、74.22%、86.07%;诊断内膜增生的AUC分别为0.712、0.726、0.904,敏感度分别为85.61%、80.19%、91.23%,特异度分别为74.27%、72.63%、85.52%;诊断不典型增生的AUC分别为0.786、0.679、0.926,敏感度分别为79.28%、76.86%、93.04%,特异度分别为69.87%、69.91%、86.17%;诊断内膜息肉的AUC分别为0.763、0.674、0.895,敏感度分别为80.34%、79.43%、84.35%,特异度分别为71.32%、69.87%、80.13%;诊断内膜癌的AUC分别为0.790、0.668、0.917,敏感度分别为80.03%、74.07%、91.04%,特异度分别为72.34%、71.72%、84.27%。结论HS、TVS对围绝经期异常子宫出血及病因均具有较高诊断价值,二者联合检查可提高诊断敏感度、特异度,临床诊断中应据患者实际情况酌情选择诊断方式,提高诊断符合率。Objective To analyze the diagnostic value of hysteroscopy(HS)combined with transvaginal sonography(TVS)for abnormal uterine bleeding in perimenopause.Methods 60 patients with abnormal uterine bleeding in perimenopause were selected.All of them underwent HS and TVS examinations,and the diagnostic compliance rates of HS and TVS single and combined examinations were compared and their diagnostic efficacy was analyzed with the pathological results as the"gold standard".Results The pathological diagnosis results showed that there were 15 cases of submucosal fibroids,18 cases of endometrial hyperplasia,7 cases of atypical hyperplasia,16 cases of endometrial polyps,and 4 cases of endometrial cancer.The diagnostic compliance rate of HS examination(88.33%)was higher than that of TVS examination(73.33%),and the diagnostic compliance rate of the combined examination(98.33%)was higher than that of single HS or TVS examination(P<0.05).The results of receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for diagnosing submucosal fibroids were 0.834,0.781 and 0.961,with sensitivities of 82.45%,80.24%and 92.70%,and specificities of 76.42%,74.22%and 86.24%;AUCs for diagnosing endometrial hyperplasia were 0.712,0.726 and 0.904,with sensitivities of 85.61%,80.19%and 91.23%,and sensitivities of 74.27%,72.63%and 85.52%;AUCs for diagnosing atypical hyperplasia were 0.786,0.679 and 0.926,with sensitivities of 79.28%,76.86%and 93.04%,and specificities of 69.87%,69.91%and 86.17%;AUCs for diagnosing endometrial polyps were 0.763,0.674 and 0.895,with sensitivities of 80.34%,79.43%and 84.35%,and specificities of 71.32%,69.87%and 80.13%;AUCs for diagnosing endometrial cancer were 0.790,0.668 and 0.917,with sensitivities of 80.03%,74.07%and 91.04%,and specificities of 72.34%,71.72%and 84.27%.Conclusion HS and TVS have high diagnostic value for abnormal uterine bleeding and its etiology in perimenopause,and the combined examination of the two can improve the diagnostic sensitivity and specificity.In clin

关 键 词：围绝经期 异常子宫出血 宫腔镜 经阴道超声 诊断 

分 类 号：R711.52[医药卫生—妇产科学]