目的：探讨经阴道超声（ TVS）和宫腔镜对异常子宫出血的诊断价值。方法对2012年1月至2014年12月因异常子宫出血就诊于本院的226例患者进行TVS和宫腔镜检查，并在宫腔镜下行病理检查，将TVS和宫腔镜检查结果与病理结果对比。结果 TVS的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为94．12％、45．21％、78．26％、78．57％及78．26％；宫腔镜的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为99．35％、89．04％、95．00％、98．48％及95．00％。结论诊断异常子宫出血TVS及宫腔镜都有较高的敏感度，但是宫腔镜的特异度、阳性预测值明显升高，优于TVS。因此，TVS联合宫腔镜并定位活检是诊断异常子宫出血的最佳方法。%Objective To explore the value of the Transvaginal sonography ( TVS) and hysteroscopy in the diagnosis of abnormal uterine bleeding .Methods We observed 226 abnormal uterine bleeding patients from January 2012 to December 2014.Those patients were examined by TVS and hysteroscopy , further diagnosed by hysteroscopy in downlink pathologic examination .The sensitivity, specificity, positive predictive value , negative predictive value and accuracy of TVS and hysteroscopy were compared to pathologic results .Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the TVS were 94.12%, 45.21%, 78.26%, 78.57% and 78.26%; The sensitivity, specificity, positive predictive value , negative predictive value and accuracy of Hysteroscopy were 99.35%, 89.04%, 95.00%, 98.48%and 95.00%. Conclusions Both TVS and hysteroscopy in the diagnosis of abnormal uterine bleeding are sensitive ; the specificity of hysteroscopy is obviously higher than that of TVS .The best method for diagnosis of abnormal uterine bleeding is TVS combined hysteroscopy combined with positioning biopsy .
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