宫腔镜和超声检查联合诊治子宫内膜息肉的价值(1)
【摘要】 目的：探讨宫腔镜和超声检查联合诊治子宫内膜息肉的价值。方法：选取2016年8月-2018年8月本院可疑子宫内膜息肉患者220例，均进行超声检查，并给予宫腔镜检查、治疗，将切除内膜行病理检查。分析患者经超声、宫腔镜、超声+宫腔镜检查与病理检查的结果，以及患者经宫腔镜治疗的结果。结果：超声检查的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为77.1%、20.0%、74.5%、95.3%、4.0%，宫腔镜检查的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为95.2%、0、90.9%、95.2%、0，超声+宫腔镜检查的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为99.0%、0、94.5%、95.4%、0，其中宫腔镜、超声+宫腔镜检查的敏感度、准确度均显著高于超声检查(P<0.05)，特异度均显著低于超声检查(P<0.05);220例患者手术时间(21.4±3.6)min，术中出血量(21.2±3.8)mL，月经恢复率、复发率分别为93.6%(206/220)、2.7%(6/220);40例不孕患者中，妊娠率为80.0%(32/40)。结论：宫腔镜和超声检查联合诊治子宫内膜息肉价值高。
【关键词】 宫腔镜; 超声; 子宫内膜息肉
【Abstract】 Objective：To explore the value of hysteroscopy combined with ultrasonography in the diagnosis and treatment of endometrial polyps.Method：A total of 220 patients with suspected endometrial polyps in our hospital from August 2016 to August 2018 were selected，they were examined by ultrasonography and hysteroscopy examination and treatment，the endometrium was excised for pathological examination.The results of ultrasonography，hysteroscopy，ultrasonography+hysteroscopy and pathology were analyzed，and the results of hysteroscopy treatment were analyzed.Result：The sensitivity，specificity，accuracy，positive predictive value and negative predictive value of ultrasonography were 77.1%，20.0%，74.5%，95.3% and 4.0% respectively.The sensitivity，specificity，accuracy，positive predictive value and negative predictive value of hysteroscopy were 95.2%，0，90.9%，95.2%，0 respectively.The sensitivity，specificity，accuracy，positive predictive value and negative predictive value of ultrasound+hysteroscopy were 99.0%，0，94.5%，95.4%，0 respectively.The sensitivity and accuracy of hysteroscopy and ultrasound+hysteroscopy were significantly higher than those of ultrasound(P<0.05)，and the specificity were significantly lower than those of ultrasound(P<0.05).The operation time was(21.4±3.6)min，the amount of bleeding during operation was(21.2±3.8)mL，the menstrual recovery rate and recurrence rate were 93.6%(206/220)and 2.7%(6/220)respectively.The pregnancy rate was 80.0%(32/40)in 40 infertile patients.Conclusion：Hysteroscopy combined with ultrasonography is of high value in the diagnosis and treatment of endometrial polyps.
【Key words】 Hysteroscopy; Ultrasonography; Endometrial polyps
First-author’s address：Northeast International Hospital，Shenyang 110623，China
doi：10.3969/j.issn.1674-4985.2019.09.030
子宮内膜息肉属于一种良性病变，发生机制为雌激素作用于子宫内膜基底层促进其局灶性过度增生的发生，组成成分为内膜的间质与腺体，主要为内部血管与表面覆盖的上皮组织同时突出宫腔[1]。相关医学研究表明，在子宫内膜息肉中，良性、单纯性或复杂性增生、恶性肿瘤、不典型增生分别占总数的70.3%、11.4%～25.7%、0.8%、3.1%[2]。子宫内膜样腺癌在子宫内膜息肉癌变后形成，年龄对其造成一定程度的影响，绝经后与更年期有10%～15%的癌变率[3]。如果患者伴高血压、子宫息肉直径在1.5 cm以上、服用三苯氧胺，那么和正常人群相比，其就具有较高的癌变率。在子宫内膜息肉发生的影响因素中，年龄、月经不调是高危因素[4]。相关医学研究表明，女性患病危险性在年龄每增加10岁时增加1.75%[5]。本研究探讨宫腔镜和超声检查联合诊治子宫内膜息肉的价值，现报道如下。, 百拇医药(路静 于丽娜)
【关键词】 宫腔镜; 超声; 子宫内膜息肉
【Abstract】 Objective：To explore the value of hysteroscopy combined with ultrasonography in the diagnosis and treatment of endometrial polyps.Method：A total of 220 patients with suspected endometrial polyps in our hospital from August 2016 to August 2018 were selected，they were examined by ultrasonography and hysteroscopy examination and treatment，the endometrium was excised for pathological examination.The results of ultrasonography，hysteroscopy，ultrasonography+hysteroscopy and pathology were analyzed，and the results of hysteroscopy treatment were analyzed.Result：The sensitivity，specificity，accuracy，positive predictive value and negative predictive value of ultrasonography were 77.1%，20.0%，74.5%，95.3% and 4.0% respectively.The sensitivity，specificity，accuracy，positive predictive value and negative predictive value of hysteroscopy were 95.2%，0，90.9%，95.2%，0 respectively.The sensitivity，specificity，accuracy，positive predictive value and negative predictive value of ultrasound+hysteroscopy were 99.0%，0，94.5%，95.4%，0 respectively.The sensitivity and accuracy of hysteroscopy and ultrasound+hysteroscopy were significantly higher than those of ultrasound(P<0.05)，and the specificity were significantly lower than those of ultrasound(P<0.05).The operation time was(21.4±3.6)min，the amount of bleeding during operation was(21.2±3.8)mL，the menstrual recovery rate and recurrence rate were 93.6%(206/220)and 2.7%(6/220)respectively.The pregnancy rate was 80.0%(32/40)in 40 infertile patients.Conclusion：Hysteroscopy combined with ultrasonography is of high value in the diagnosis and treatment of endometrial polyps.
【Key words】 Hysteroscopy; Ultrasonography; Endometrial polyps
First-author’s address：Northeast International Hospital，Shenyang 110623，China
doi：10.3969/j.issn.1674-4985.2019.09.030
子宮内膜息肉属于一种良性病变，发生机制为雌激素作用于子宫内膜基底层促进其局灶性过度增生的发生，组成成分为内膜的间质与腺体，主要为内部血管与表面覆盖的上皮组织同时突出宫腔[1]。相关医学研究表明，在子宫内膜息肉中，良性、单纯性或复杂性增生、恶性肿瘤、不典型增生分别占总数的70.3%、11.4%～25.7%、0.8%、3.1%[2]。子宫内膜样腺癌在子宫内膜息肉癌变后形成，年龄对其造成一定程度的影响，绝经后与更年期有10%～15%的癌变率[3]。如果患者伴高血压、子宫息肉直径在1.5 cm以上、服用三苯氧胺，那么和正常人群相比，其就具有较高的癌变率。在子宫内膜息肉发生的影响因素中，年龄、月经不调是高危因素[4]。相关医学研究表明，女性患病危险性在年龄每增加10岁时增加1.75%[5]。本研究探讨宫腔镜和超声检查联合诊治子宫内膜息肉的价值，现报道如下。, 百拇医药(路静 于丽娜)