宫腔镜检查在异常子宫出血诊断中的临床应用价值
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何梅
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曲靖市会泽县妇幼保健院，云南曲靖，654200
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摘要：目的 探讨宫腔镜检查在异常子宫出血（Abnormal Uterine Bleeding, AUB）病因诊断中的临床应用价值，并与传统超声检查进行比较，评估其诊断准确率及优势。方法 选取2022年1月至2023年12月期间我院收治的200 例AUB 患者作为研究对象，采用随机数字表法分为宫腔镜组（n=100）和超声组（n=100）。所有患者均先行超声检查，宫腔镜组再行宫腔镜检查，并以病理组织学检查结果为“金标准”。比较两组对不同AUB 病因（如子宫内膜息肉、子宫粘膜下肌瘤、子宫内膜增生、宫腔内异物等）的检出率、诊断符合率及诊断效能（敏感度、特异度、准确率）。结果 以病理结果为金标准，宫腔镜组对AUB 病因的总诊断符合率为98.0%（98/100），显著高于超声组的85.0%（85/100），差异具有统计学意义（χ2= 10.73, P<0.01）。宫腔镜组对于子宫内膜息肉、子宫粘膜下肌瘤、子宫内膜增生不伴非典型增生等病变的检出率均显著高于超声组（P 均<0.05）。宫腔镜诊断的总体敏感度为98.9%，特异度为95.0%，准确率为98.0%，均优于超声检查（分别为88.6%、76.9%和85.0%）。结论 宫腔镜检查在AUB 的病因诊断中具有直观、准确、高效的显著优势，其诊断符合率和准确率均明显高于超声检查，能为临床制定精准治疗方案提供可靠依据，具有极高的临床应用价值。
关健词：宫腔镜检查；异常子宫出血；诊断价值；病理学；超声检查
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The clinical application value of hysteroscopy in the diagnosis of abnormal uterine bleeding
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Mei He
Qujing Huize County Maternal and Child Health Hospital，Qujing Yunnan 654200，China
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Abstract: Objective To explore the clinical application value of hysteroscopy in the etiological diagnosis of abnormal uterinebleeding (AUB), and compare it with traditional ultrasound examination to evaluate its diagnostic accuracy and advantages.Methods 200 patients with AUB admitted to our hospital from January 2022 to December 2023 were selected as the studysubjects. They were randomly divided into hysteroscopy group (n=100) and ultrasound group (n=100) using a random numbertable method. All patients underwent ultrasound examination first, followed by hysteroscopy in the hysteroscopy group, withhistopathological examination results as the“ gold standard”. Compare the detection rate, diagnostic accuracy, and diagnosticefficacy (sensitivity, specificity, accuracy) of two groups for different causes of AUB, such as endometrial polyps, submucosalfibroids, endometrial hyperplasia, and intrauterine foreign bodies.Results Using pathological results as the gold standard,the overall diagnostic accuracy rate of AUB etiology in the hysteroscopy group was 98.0% (98/100), significantly higher thanthe 85.0% (85/100) in the ultrasound group, and the difference was statistically significant (χ2=10.73, P<0.01). The detectionrate of endometrial polyps, submucosal fibroids, and endometrial hyperplasia without atypical hyperplasia in the hysteroscopygroup was significantly higher than that in the ultrasound group (all P<0.05). The overall sensitivity, specificity, and accuracy ofhysteroscopy diagnosis were 98.9%, 95.0%, and 98.0%, respectively, which were superior to ultrasound examination (88.6%, 76.9%, and 85.0%). Conclusion Hysteroscopy has significant advantages in intuitive, accurate, and efficient etiological diagnosisof AUB, with significantly higher diagnostic accuracy and conformity than ultrasound examination. It can provide reliableevidence for the development of precise treatment plans in clinical practice and has high clinical application value.
Keywords : hysteroscopy examination; Abnormal uterine bleeding; Diagnostic value; Pathology; Ultrasound examination
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