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目的对比宫腔镜和经阴道超声检查诊疗绝经后子宫的出血状况,对其临床状况进行观察,并做好相应的记录工作。方法选取我院2013年3月到2014年3月收治的绝经后子宫出血患者120例,并对所有患者进行宫腔镜和阴道超声检查。要以病理结果为金标准,将两种方式的结果和病理组织进行比较,对比两种检查方式的敏感度、特异性、阳性预测率以及阴性预测率等。结果 120例患者中27例经阴道超声检查为正常,其中15例患者病理证实子宫内膜无异常。40例经阴道超声检查诊断为宫腔病变的患者,其病理证实38例。在子宫内膜增生过长、子宫内膜癌及子非器质性因素诊断敏感度以及阳性预测值中,宫腔镜明显要优于引导超声检查;而在子宫内膜息肉和子宫粘膜下肌瘤的诊断中,两种检查方式的敏感度以及阳性预测值没有明显差异。结论宫腔镜在绝经后子宫出血诊断中比阴道超声检查在临床上更具广泛性,其数据诊断价值更高,可以提升诊断准确率,为患者后续治疗提供保障。
Objective To compare the hysteroscopy and transvaginal ultrasonography in the diagnosis and treatment of postmenopausal uterine bleeding and to observe its clinical status and make corresponding records. Methods A total of 120 patients with postmenopausal uterine bleeding who were treated in our hospital from March 2013 to March 2014 were enrolled. All patients underwent hysteroscopy and vaginal ultrasonography. To the pathological results of the gold standard, the results of the two ways and pathological tissue were compared to compare the sensitivity of the two test methods, specificity, positive predictive rate and negative predictive rate. Results Among 120 patients, 27 cases were normal by transvaginal ultrasonography, of which 15 cases showed no abnormal endometrium. 40 cases of transvaginal ultrasound diagnosis of uterine lesions in patients with pathological confirmed 38 cases. In the endometrial hyperplasia, endometrial cancer and child non-organic factors diagnostic sensitivity and positive predictive value, hysteroscopy was better than guided ultrasound; and in the endometrial polyps and uterine submucosa In the diagnosis of neoplasia, there was no significant difference between the sensitivity of the two tests and the positive predictive value. Conclusions Hysteroscopy in the diagnosis of postmenopausal uterine bleeding than vaginal ultrasound is more extensive in the clinical diagnosis of its higher value, can improve the diagnostic accuracy, follow-up treatment for patients to provide protection.