【摘要】：目的： 探討經(jīng)陰道彩色多普勒超聲、宮腔鏡檢查、病理學(xué)檢查對宮腔病變的診斷價值。以便臨床影響醫(yī)生根據(jù)患者不同情況選擇合適的檢查技術(shù)，，盡可能使患者減少因檢查造成的不必要的損傷。 方法： 隨機選擇2010年1月至2014年1月因臨床懷疑宮腔病變的住院患者394例，在知情同意后對所有患者先行陰道多普勒超聲檢查法，再行宮腔鏡檢查，最后經(jīng)病理學(xué)檢查確診。記錄并比較經(jīng)陰道彩色多普勒超聲檢查和宮腔鏡檢查對宮腔病變顯示情況，進行對比。計數(shù)資料以率、構(gòu)成比指標(biāo)進行描述，運用2檢驗、kappa值等方法進行假設(shè)檢驗。 結(jié)果： 1.子宮內(nèi)膜息肉、胚胎殘留、粘膜下肌瘤患者在年齡、居住地性質(zhì)、生育史、流產(chǎn)史、仍有月經(jīng)方面存在差異；2.子宮內(nèi)膜息肉、胚胎殘留、粘膜下肌瘤患者臨床表現(xiàn)均以陰道不規(guī)則出血為主；3.在診斷子宮內(nèi)膜息肉方面，多普勒超聲檢查結(jié)果與病理檢查結(jié)果一致性較好，但是診斷率較低；宮腔鏡檢查結(jié)果與病理檢查結(jié)果一致性較差，但是診斷率較高。4.在診斷粘膜下肌瘤方面，多普勒超聲檢查、宮腔鏡檢查與病理檢查結(jié)果一致性均較好，且多普勒超聲檢查診斷率高于宮腔鏡檢查。 結(jié)論： 1.宮腔病變患者以30～50歲年齡段、城市居民、有過生育史和流產(chǎn)史的婦女為主，且子宮內(nèi)膜息肉、粘膜下肌瘤、胚胎殘留在年齡、居住地性質(zhì)、有過生育史和流產(chǎn)史方面分布不同。2.宮腔占位性病變患者以陰道不規(guī)則出血、月經(jīng)量增多和月經(jīng)經(jīng)期延長為主要臨床表現(xiàn)。3.陰道多普勒超聲檢查與病理檢查結(jié)果具有較好的一致性,可作為首選檢查手段。4.對于宮腔占位性病變，陰道多普勒超聲檢查與臨床癥狀檢查均有較好診斷價值，且二者聯(lián)合診斷價值最佳。
[Abstract]:Objective: to evaluate the diagnostic value of transvaginal color Doppler ultrasound, hysteroscopy and pathology in uterine cavity lesions. In order to affect the clinical doctor to choose the appropriate examination technology according to the different conditions of the patient, so as to reduce the unnecessary injury caused by the examination as much as possible. Methods: from January 2010 to January 2014, 394 inpatients with suspected uterine lesions were randomly selected. All patients were examined by vaginal Doppler ultrasound after informed consent, followed by hysteroscopy, and finally confirmed by pathological examination. Transvaginal color Doppler ultrasound and hysteroscopy were recorded and compared. The counting data are described by rate and constituent ratio index, and the hypothesis test is carried out by means of 2 test and kappa value. Result: 1. There are still differences in age, place of residence, reproductive history, abortion history and menstruation in patients with endometrial polyp, embryo residue and submucous myoma. The clinical manifestations of uterine polyp, embryo residue and submucous myoma were mainly irregular vaginal bleeding. In the diagnosis of endometrial polyps, the results of Doppler ultrasound were in good agreement with the results of pathological examination, but the diagnostic rate was low, and the results of hysteroscopy were in poor agreement with the results of pathological examination, but the diagnostic rate was high. 4. In the diagnosis of submucous myoma, the results of Doppler ultrasound, hysteroscopy and pathology were in good agreement, and the diagnostic rate of Doppler ultrasound was higher than that of hysteroscopy. Conclusion: 1. The patients with uterine cavity lesions were 30 years old, 50 years old, urban residents, women with reproductive history and abortion history, and the distribution of endometrial polyps, submucous myoma and embryo residues in age, residence nature, reproductive history and abortion history were different. 2. The main clinical manifestations of uterine space-occupying lesions were irregular vaginal bleeding, increased menstrual volume and prolonged menstrual period. The results of vaginal Doppler ultrasound were in good agreement with those of pathological examination, and could be used as the first choice. 4. Vaginal Doppler ultrasound and clinical symptom examination have good diagnostic value for uterine space-occupying lesions, and the combined diagnosis value of vaginal Doppler ultrasound and clinical symptoms is the best.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.1;R711.74

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