本文選題：經(jīng)陰道超聲　切入點(diǎn)：宮腔鏡　出處：《重慶醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的評估經(jīng)陰道超聲(transvaginal sonography，TVS)及宮腔鏡診斷不孕不育患者宮腔異常的臨床應(yīng)用價值。 方法回顧性分析324例不孕不育患者TVS的及宮腔鏡檢查結(jié)果，以宮腔鏡結(jié)果作為金標(biāo)準(zhǔn)，計算經(jīng)陰道超聲診斷宮腔異常的ROC曲線下面積(area under the ROC curve,AUC)、陽性似然比（positive likelihoodratios,LR+)、陰性似然比(negative likelihood ratios,LR-)、敏感度、特異度、陽性預(yù)測值（positive predictive value,PPV）和陰性預(yù)測值（negativepredictive value,NPV)。 結(jié)果TVS診斷宮腔異常的AUC為0.811、LR+為2.87、LR-為0.07、敏感度為95.5%、特異性度66.7%、陽性預(yù)測值為98.7%、陰性預(yù)測值為36.4%；其中TVS診斷宮腔粘連的宮腔粘連的AUC為0.880、LR+為10.38、LR-為0.17、敏感度為84.1%、特異度為91.9%、陽性預(yù)測值為86.9%、陰性預(yù)測值為90.0%；TVS診斷子宮內(nèi)膜炎的AUC為0.821、LR+為7.23、LR-為0.28、敏感度為74.5%、特異度為89.7%、陽性預(yù)測值為78.8%、陰性預(yù)測值為87.3%；TVS診斷子宮內(nèi)膜息肉的AUC為0.893、LR+為17.35、LR-為0.18、敏感度為83.3%、特異度為95.2%、陽性預(yù)測值為83.3%、陰性預(yù)測值為95.2%。 結(jié)論經(jīng)陰道超聲可了解子宮形態(tài)及宮腔內(nèi)異常情況，具有安全無創(chuàng)、有效、操作簡單、可重復(fù)性強(qiáng)等特點(diǎn)，可作為診斷宮腔異常的篩查方法。宮腔鏡對慢性子宮內(nèi)膜炎的診斷具有確診意義。
[Abstract]:Objective to evaluate the clinical value of transvaginal sonography (TVs) and hysteroscopy in the diagnosis of abnormal uterine cavity in infertile patients. Methods the results of TVS and hysteroscopy in 324 infertile patients were analyzed retrospectively. The area under the ROC curve of transvaginal ultrasound for diagnosing abnormal uterine cavity was area under the ROC curveted AUC, positive likelihood was higher than positive likelihoodratiosLR, negative likelihood was negative elihoodratia LR, sensitivity, specificity, positive predictive value) and negative predictive value were negative predictive value (NPV) and negative predictive value (NPV). Results the AUC of TVS for the diagnosis of abnormal uterine cavity was 0.811 LR-, the sensitivity was 95.55.The specificity was 66.7, the positive predictive value was 98.7 and the negative predictive value was 36.4.The AUC value of TVS in the diagnosis of intrauterine adhesion was 0.880 LR- was 10.38 LR- 0.17, the sensitivity was 84.1%, the sensitivity was 84.1%, and the negative predictive value was 36.4%, among which the AUC of TVS in the diagnosis of intrauterine adhesions was 10.38 LR- 0.17, and the sensitivity was 84.1%. The difference is 91.9, the positive predictive value is 86.9, the negative predictive value is 90.0 and the AUC of TVs for the diagnosis of endometritis is 0.821, LR is 7.23 LR- is 0.28, the sensitivity is 74.5, the specificity is 89.7, the positive predictive value is 78.8, the negative predictive value is 87.33 TVs in the diagnosis of endometrial polyps, the AUC is 0.893LR is 0.893LR. 17.35 LR- was 0.18, sensitivity was 83.3, specificity was 95.2, positive predictive value was 83.3, negative predictive value was 95.2. Conclusion Transvaginal ultrasound is safe, effective, simple and reproducible for the understanding of uterine morphology and intrauterine abnormalities. Hysteroscopy is useful in the diagnosis of chronic endometritis.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R711.6

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