【摘要】 目的探讨阴道超声和宫腔镜检查诊断围绝经期子宫异常出血的临床应用价值。方法收集患者180例,以病理检查结果作为"金标准",比较阴道超声和宫腔镜检查的灵敏度及阳性预测的价值。结果在子宫内膜过度增生、子宫内膜癌、未见明显占位性病变(正常子宫内膜、子宫内膜炎、萎缩性子宫内膜)的诊断中,阴道超声检查的灵敏度分别为77.3%、57.1%、82.2%,宫腔镜检查的灵敏度分别为97.7%、92.9%、95.6%,两组之间的差异有统计学意义(P<0.05)。在子宫内膜息肉、子宫内膜过度增生的诊断中,阴道超声检查的阳性预测价值为79.7%和75.6%,宫腔镜检查的阳性预测价值为96.2%和93.5%,两组之间的差异有统计学意义(P<0.05)。结论阴道超声可以作为围绝经期妇女临床筛检的常规方法 ,宫腔镜检查可以作为在阴道超声发现宫腔异常情况或不能明确时进一步检查的重要手段。更多还原

【Abstract】 Objective To investigate the clinical value of transvaginal sonography and hysteroscopy for the diagnosis of abnormal uterine bleeding in perimenopausal women.Method Data from 180 patients were collected and compiled as the"gold standard" for comparing the sensitivity and positive predictive value of transvaginal sonography and hysteroscopy.Results The sensitivity of hysteroscopy was significantly higher than that of transvaginal sonography(97.7%,92.9%,95.6% vs 77.3%,57.1%,82.2%)in diagnosis of endometrial hyperplasia,endometrial carcinoma and non-space occupying lesions of endometrium(normal endometrium,endometritis and atrophic endometrium).The positive predictive value of hysteroscopy was significantly higher than that of transvaginal sonography(96.2%,93.5% vs 79.7%,75.6%)in diagnosis of endometrial ployp and endometrial hyperplasia.Conclusions Transvaginal ultrasound can be used as a conventional method for clinical screening in perimenopausal women.Hysteroscopy can be used in the finding of intrauterine abnormalities,especially in the patients with unknown situation or after transvaginal ultrasound examination.更多还原