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目的探讨阴道镜和宫颈刮片在妇女宫颈病变普查和确诊中的应用价值。方法 1 991例妇检者分别行阴道镜检查和宫颈刮片,对阴道镜检查有异常图像者做病理检测,并以病理检查结果为准。比较宫颈刮片和阴道镜检查对宫颈疾病的检出率和诊断符合率,以及两者联合检查的准确性。结果 1 991例妇检者中,宫颈刮片结果异常86例,异常检出率4.32%;阴道镜检出有异常图像47例,异常检出率2.36%,两者异常检出率有统计学差异(P<0.05)。47例阴道镜异常病例做病理检查,其中慢性宫颈炎29例,CINⅠ10例,CINⅡ3例,CINⅢ4例,腺癌1例。宫颈刮片诊断符合率为51.43%,阴道镜诊断符合率为94.74%,两种方法联合诊断宫颈病变与阴道镜下病理活检诊断率相近,提示宫颈刮片细胞学检查联合阴道镜检查对宫颈疾病的诊断水平与组织病理检测相当。结论宫颈刮片细胞学检测和阴道镜检查两者联合可提高检出率,降低假阳性率,提高宫颈病变诊断的准确性,可作为临床筛查宫颈癌的推荐方法。
Objective To investigate the value of colposcopy and cervical smears in the screening and diagnosis of cervical lesions in women. Methods One hundred and ninety-one women underwent colposcopy and cervical smears, respectively, and pathological examination was performed on those with abnormal images of colposcopy. The pathological examination results should prevail. Cervical smears and colposcopy compared the detection rate of cervical disease and diagnosis of coincidence rate, as well as the combined examination of both accuracy. Results Among 1 991 women, 86 cases had abnormal results of cervical smear and the rate of abnormality was 4.32%. There were 47 cases of abnormal images detected by colposcopy and the rate of abnormality was 2.36%. There was a statistically significant difference between the two methods Difference (P <0.05). 47 cases of abnormal colposcopy pathological examination, of which 29 cases of chronic cervicitis, CIN Ⅰ 10 cases, CIN Ⅱ 3 cases, CIN Ⅲ 4 cases, 1 case of adenocarcinoma. Cervical smear diagnosis coincidence rate was 51.43%, colposcopy diagnostic coincidence rate was 94.74%, the two methods combined diagnosis of cervical lesions and colposcopy pathological biopsy diagnosis rate, suggesting that cervical smear cytology combined with colposcopy cervical disease The diagnostic level and histopathological detection of considerable. Conclusion Cervical smears combined with colposcopy and colposcopy can improve the detection rate, reduce the false positive rate and improve the accuracy of cervical lesions diagnosis, which can be used as a recommended method for clinical screening of cervical cancer.