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目的探讨宫腔镜在绝经后子宫出血中的临床诊断价值。方法 126例绝经后子宫出血的患者为研究对象,上述患者入院后先后接受阴道超声和宫腔镜检查,以病理检查结果为标准,对两种检查方式的诊断结果进行评价。结果病理提示子宫内膜非特异性病变64例(50.79%),子宫内膜息肉18例(14.29%),子宫黏膜下肌瘤13例(10.32%),子宫内膜增殖24例(19.05%),子宫内膜癌7例(5.56%),阴道超声的阳性预测值依次为74.24%、47.62%、44.44%、69.23%、50.00%,宫腔镜阳性预测值依次为93.85%、78.95%、75.00%、95.83%、100%,两种检查方式比较差异具有统计学意义(P<0.05);宫腔镜在子宫内膜非特异性病变和子宫内膜增殖中的敏感性明显好于阴道超声,差异有统计学意义(P<0.05)。结论宫腔镜检查在绝经后子宫出血相关疾病的检出率和敏感性较高,值得临床推广应用。
Objective To investigate the clinical value of hysteroscopy in postmenopausal uterine bleeding. Methods A total of 126 patients with postmenopausal uterine bleeding were enrolled in the study. The patients received vaginal ultrasound and hysteroscopy after admission. The diagnostic results of the two examinations were evaluated based on the pathological findings. Results The pathological findings of endometrial nonspecific lesions in 64 cases (50.79%), 18 cases of endometrial polyps (14.29%), uterine fibroids in 13 cases (10.32%), endometrial proliferation in 24 cases (19.05% The positive predictive values of vaginal ultrasound were 74.24%, 47.62%, 44.44%, 69.23%, 50.00% respectively. The positive predictive values of hysteroscopy were 93.85%, 78.95%, 75.00% , 95.83%, 100%, respectively. There was significant difference between the two test methods (P <0.05). The sensitivity of hysteroscopy in non-specific endometrial lesions and endometrial hyperplasia was significantly better than that of vaginal ultrasound Statistical significance (P <0.05). Conclusion Hysteroscopy in the detection of postmenopausal bleeding related diseases, the detection rate and sensitivity is high, it is worth promoting the clinical application.