阴道超声及宫腔镜诊断子宫内膜息肉的临床价值.docVIP

阴道超声及宫腔镜诊断子宫内膜息肉的临床价值 　　[摘要] 目的 探讨阴道B超（TVS）及宫腔镜（HS）对子宫内膜息肉（EP）的诊断价值。 方法 回顾性分析2010年1月～2014年9月行TVS及HS的患者524例的临床资料，将病理结果与TVS诊断及HS诊断进行对比分析。 结果 病理报告EP 284例，TVS诊断EP的敏感性为72.5%，特异性为74.2%，假阴性率为27.5%，假阳性率为25.8%，TVS与病理诊断EP的符合率为73.3%，HS诊断EP的敏感性为87.3%，特异性为89.6%，假阴性率为12.7%，假阳性率为10.4%。HS与病理诊断EP的符合率为88.4%。 结论 TVS是诊断EP的一种无创、安全、简便的检查方法，可用于初步筛查。HS诊断EP的准确性高于TVS，是理想的确诊EP的方法。二者联合检查，可提高EP的确诊率。 　　[关键词] 阴道B超；宫腔镜；子宫内膜息肉；诊断；病理 　　[中图分类号] R711.74 [文献标识码] A [文章编号] 2095-0616（2015）19-15-04 　　[Abstract] Objective To evaluate the diagnositic value of transvaginal sonography（TVS） and hysteroscopy（HS） for endometrial polyps（EP）. Methods 524 cases received TVS firstly and then HS was carried out in the hospital from January 2010 to September 2014， the pathological diagnosis after surgery was used as diagnostic criterion， all the cases were retrospectively analyzed. The diagnosis of transvaginal sonography and hysteroscopy was compared with pathological examination.The diagnostic accordance rates of TVS and HS were compared. Results 284 cases of EP confirmed by pathology. The sensitivity， specificity， false negative rate and false positive rate of transvaginal sonography with pathological examination for diagnosis of endometrial polyp was 72.5%， 74.2%， 27.5% and 25.8% respectively， while the sensitivity， specificity， false negative rate and false positive rate of hysteroscopy with pathological examination was 87.3%， 89.6%， 12.7% and 10.4% respectively. The accordance rate of TVS for EP was 73.3%， and the accordance rate of HS for EP was 88.4%. Conclusion Diagnosis of EP by TVS is non-invasive， safe and easy， so it becomes the preferred screening method for EP. Diagnosis of endometrial polyps by HS are more accurate than TVS. HS is a ideal diagnositic method. HS combined with TVS can significantly improve the accuracy of diagnosis for endometrial polyps. 　　[Key words] Transvaginal sonography； Hysteroscopy； Endometrial polyps； Diagnosis； Pathology 　　子宫内膜息肉（endometrial polyps，EP）是妇科常见的宫腔内良性占位病变，主要临床