【摘要】：目的探討宮腔鏡窄帶成像下診治子宮內(nèi)膜增生性病變的臨床應(yīng)用價值。方法選取118例異常子宮出血患者行宮腔鏡檢查,分別使用白光和窄帶成像技術(shù)(NBI)模式對子宮內(nèi)膜進行PLAM-COEIN分類和病灶性質(zhì)的判斷,以病理診斷作為金標準,比較兩種檢查模式對子宮內(nèi)膜病變診治的作用。結(jié)果 NBI在顯示病灶輪廓、微血管清晰度方面明顯優(yōu)于白光模式(χ~2=48.020,P=0.000);白光與NBI模式下診斷與病理診斷Kappa值分別為0.605和0.911,NBI診斷與病理診斷一致性較好;病理陽性病灶(子宮內(nèi)膜增生性病變)88例陰性病灶(非結(jié)構(gòu)異常COEIN病例)30例。根據(jù)高于周邊內(nèi)膜的不規(guī)則突起或明顯贅生物,質(zhì)地堅韌或糟脆,新生異型血管豐富,白光和NBI模式診斷子宮內(nèi)膜增生性病變的準確率分別為83.05%和96.61%(χ~2=11.874,P=0.001),敏感性分別為81.82%和97.73%(χ~2=12.129,P=0.000),特異性分別為86.67%和93.33%(χ~2=0.671,P=0.335)。結(jié)論 NBI可清晰地觀察子宮內(nèi)膜病變的輪廓及微血管形態(tài)變化,有助于其性質(zhì)及程度的判斷,減少漏診,NBI引導(dǎo)下子宮內(nèi)膜病變的定位活檢具有良好的臨床應(yīng)用價值。
[Abstract]:Objective to evaluate the clinical value of narrow-band hysteroscopy in the diagnosis and treatment of endometrial hyperplasia. Methods 118 patients with abnormal uterine hemorrhage were examined by hysteroscopy. The PLAM-COEIN classification and the nature of endometrium were determined by (NBI) mode of white light and narrow band imaging respectively. The pathological diagnosis was taken as the golden standard. To compare the role of two examination modes in the diagnosis and treatment of endometrial lesions. Results NBI was superior to the white light mode in displaying the shape of lesion and the definition of microvessel (蠂 ~ 2 ~ (48.020) P ~ (0.000). The diagnostic and pathological Kappa values of white light and NBI were 0.605 and 0.911 respectively, and the pathological positive lesions (endometrial proliferative lesions) in 88 negative lesions (non-structural abnormal COEIN cases) in 30 cases. According to irregular processes or obvious vegetations higher than the peripheral endometrium, the texture was tough or brittle, and the neovascularization was abundant. The accuracy of diagnosis of endometrial hyperplasia by white light and NBI was 83.05% and 96.61%, respectively (蠂 ~ 2 ~ (11.874), P < 0.05). The sensitivity and specificity were 81.82% and 97.73% respectively (蠂 ~ 2 ~ (12.129) P ~ (0.000), and the specificity were 86.67% and 93.33% (蠂 ~ (2), respectively (蠂 ~ (2) 0.671P ~ (0.335). Conclusion NBI can clearly observe the contour and microvascular morphology of endometrial lesions, which is helpful to judge the nature and degree of endometrial lesions and reduce missed diagnosis. NBI guided localization biopsy of endometrial lesions has a good clinical value.
【作者單位】： 大連醫(yī)科大學(xué)附屬大連市婦產(chǎn)醫(yī)院暨大連市婦幼保健院婦科;
【分類號】：R711.74

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