宫腔镜和超声波对子宫内膜息肉诊断价值的比较

摘要

objective: Study on the value of the diagnosis of endometrial polyps by hysteroscopic and ultrasound and provide a reference basis. Methods:There are 1338 cases in survey for gynecologial examination of patients during December 2004 to December 2010 in a hospital in guangzhou , all patients for ultrasonic, hysteroscopy and curettage after a pathologic examination, and compare the diagnosis results by ultrasonic and hysteroscopy with pathologic examination as the gold standard. Results:There were 428 cases of endometrial polyps by pathological diagnosis, the sensitivity, specificity and Youden’s index by ultrasound diagnosis of endometrial polyps were 61.21%, 91.87%, 0.53 respectively; but were 95.33%, 99.23%, 0.95 by Hysteroscopy diagnosis, there were difference obviously between the two kinds of test methods (P<0.01).Ultrasonic detection rate is 61.45%, but the detection rate is 99.30% by combined method of Ultrasonic and hysteroscopy, there were difference obviously in two ways (P < 0.01).Conclusion: Ultrasound is a kind of examination method without trauma and simple operation, can be used as endometrial polyps screening method, but the false negative rate is high. Hysteroscopy diagnosis coincidence rate is high, accurate, intuitive, safety, but the operation is complicated. Ultrasonic and Hysteroscopy joint inspection can make up for their respective deficiencies, is a good method of the diagnosis of endometrial polyps.%目的：探讨宫腔镜与超声波在诊断子宫内膜息肉上的价值，为子宫内膜息肉的诊断提供参考依据。方法：调查2004年12月至2010年12月在广州某医院进行妇科检查的患者1338例，患者均进行超声、宫腔镜及诊刮后送病理检查，以病理检查作为金标准，超声波和宫腔镜的诊断结果与之进行比较。结果：病理诊断子宫内膜息肉428例，超声诊断子宫内膜息肉的灵敏度、特异度、正确指数分别为61.21%、91.87%、0.53；宫腔镜诊断子宫内膜息肉的灵敏度、特异度、正确指数分别为95.33%、99.23%、0.95，两种检验方法比较差异有统计学意义（P<0.01）。超声波与宫腔镜联合检查和超声检查诊断子宫内膜息肉的比较中，超声波的检出率为61.45%，超声波与宫腔镜联合检出率为99.30%，两种检验方法比较差异有统计学意义（P<0.01）。结论：超声波是一种无创伤、操作简单的检查方法，可作为子宫内膜息肉的筛查手段，但漏诊率偏高。宫腔镜诊断的符合率高，准确且直观，但操作较繁杂。超声波与宫腔镜联合检查可弥补各自的缺陷，是诊断子宫内膜息肉的较好的方法。