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

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 diagno -sis,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 abnor-mal uterine bleeding.All subjects were underwent transvaginal ultrasonography,hysteroscopy under the line under the in-spection line segmented curettage,and do pathological diagnosis.Results The best cutoff value of endometrial thick-ness 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,pos-itive 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 endom-etrial thickness.HS has a high coincidence rate in the diagnosis of benign and malignant endometrial lesions,which can improve the accuracy.