B超和宫腔镜对子宫内膜息肉诊断价值探讨.doc

B超和宫腔镜对子宫内膜息肉诊断价值探讨 　　【摘要】目的：比较B超和宫腔镜对子宫内膜息肉（EP）的诊断价值。方法：对355例阴道异常出血、绝经后子宫内膜增厚或不孕的患者进行阴道B超及宫腔镜检查，以病理诊断为标准，计算两种方法与最后病理的诊断符合率、敏感性、特异性、假阴性率、假阳性率。结果：阴道B超对子宫内膜息肉的诊断的符合率、敏感性、特异性、假阴性率、假阳性率分别为6250%、7792%、8705%、1295%、2208%。宫腔镜对子宫内膜息肉的诊断符合率、敏感性、特异性、假阴性率、假阳性率分别为8941%、9268%、9670%、330%、732%。结论：阴道B超诊断子宫内膜息肉与病理的符合率较低，因其无创、方便和快捷， 可作为子宫内膜息肉术前筛查和术后随访的手段。宫腔镜诊断子宫内膜息肉具有更高的病理符合率、敏感性和特异性，可作为诊断其的首选检查方法。 　　【关键词】 宫腔镜；诊断；子宫内膜息肉 　　Discussion on the ultrasound and hysteroscopy in the diagnosis of endometrial polypWANG Xuan， XIAO Qun， WAN Anxia△. Department of Gynecology and Obstetrics， Xuanwu Hospital of Capital Medical University， Beijing 100053， China 　　【Abstract】Objectives： To analyze the value of hysteroscopy and transvaginal ultrasound in the diagnosis of endometrial polyp. Methods： A total of 355 patients with abnormal metrorrhagia or infertility were tested by ultrasound and hysteroscopy， followed by biopsy during hysteroscopy. The diagnose accordance rate， sensitivity， specificity， false negative rate and false positive rate were calculated and compared between the two approaches against the pathological standard. Results： The diagnose accordance rate， sensitivity， specificity， false negative rate and false positive rate of ultrasound with pathological examination in diagnosing EP was 62.50%， 77.92%， 87.05%， 12.95%， 22.08% respectively. The diagnose accordance rate， sensitivity， specificity， false negative rate and false positive rate of hysteroscopy with pathological examination in diagnosing EP was 89.41%， 92.68%， 96.70%， 330% and 7.32% respectively. Conclusion： The coincidence rate of ultrasound is lower than hysteroscopy by pathological standard. As a non-invaded， convenient and shortcut method， ultrasound can be used in preoperative screening and postoperative follow-up visiting. Hysteroscopy can be used as a first selected method in EP diagnosing because of its higher coincidence rate， sensitivity and specificity. 　　【Key words】Hysteroscopy； Diagnosis； Endometrial polyp 　　【中