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目的探讨阴道超声和宫腔镜检查对不孕患者子宫内膜病变的诊断价值。方法对在我中心不孕门诊进行阴道超声、宫腔镜检查的152例患者分为两组进行对照分析。自然周期超声监测内膜回声异常的105例为研究组,超声监测内膜正常的47例为对照组。结果研究组宫腔镜检查确诊内膜病变为84例(80.00%),对照组为4例(8.51%),两组比较差异有非常显著性意义(P<0.001)。研究组中,子宫内膜息肉占30.48%(32/105),内膜增殖36.19%(38/105),粘膜下肌瘤0.95%(1/105),输卵管阻塞8.57%(9/105),内膜炎症3.81%(4/105);对照组异常内膜为内膜粘连4.25%(2/47),内膜炎症4.25%(2/47)。以宫腔镜结果为金标准,经阴道超声监测对子宫内膜病变诊断的敏感度95.45%(84/88),特异度67.19%(43/64)。研究组确诊内膜异常者84例,妊娠率46.43%(39/84),对照组确诊为内膜正常者43例,妊娠率74.41%(32/43),两组比较差异有显著意义(P<0.05)。结论阴道超声是诊断不孕症患者宫腔内病变的一种简便、廉价、无创伤、诊断率高的方法,可以作为不孕患者宫腔镜检查的初筛,而宫腔镜检查则为内膜病变提供准确的诊断。
Objective To investigate the value of vaginal ultrasound and hysteroscopy in the diagnosis of endometrial lesions in infertility patients. Methods A total of 152 patients undergoing vaginal ultrasound and hysteroscopy in our center infertility clinic were divided into two groups and compared. 105 cases of spontaneous echocardiographic endometrial echocardiography were selected as the study group, and 47 cases whose eutopic endometrial ultrasound was normal were selected as the control group. Results There were 84 cases (80.00%) of endometrial lesions confirmed by hysteroscopy in study group and 4 cases (8.51%) in control group. There was significant difference between the two groups (P <0.001). In the study group, endometrial polyps accounted for 30.48% (32/105), endometrial hyperplasia 36.19% (38/105), submucosal fibroids 0.95% (1/105), tubal occlusion 8.57% (9/105) Intimal inflammation was 3.81% (4/105). In control group, the abnormal intima was 4.25% (2/47) intimal adhesion and 4.25% (2/47) intimal inflammation. The hysteroscopy results as the gold standard, the sensitivity of transvaginal ultrasound in the diagnosis of endometrial lesions was 95.45% (84/88) and the specificity was 67.19% (43/64). The study group 84 cases of endometrial abnormalities, the pregnancy rate was 46.43% (39/84), the control group was diagnosed as normal intimal 43 cases, the pregnancy rate was 74.41% (32/43), the difference between the two groups was significant (P <0.05). Conclusions Vaginal ultrasonography is a simple, inexpensive, non-invasive and high-diagnostic method for the diagnosis of intrauterine lesions in infertile patients, which can be used as the primary screening for hysteroscopy in infertility patients, while the hysteroscopy Membranous lesions provide an accurate diagnosis.