阴道彩色多普勒超声在宫腔病变诊断中的应用价值研究

发布时间：2019-06-24 13:50

【摘要】：目的：探讨经阴道彩色多普勒超声、宫腔镜检查、病理学检查对宫腔病变的诊断价值。以便临床影响医生根据患者不同情况选择合适的检查技术，，尽可能使患者减少因检查造成的不必要的损伤。方法：随机选择2010年1月至2014年1月因临床怀疑宫腔病变的住院患者394例，在知情同意后对所有患者先行阴道多普勒超声检查法，再行宫腔镜检查，最后经病理学检查确诊。记录并比较经阴道彩色多普勒超声检查和宫腔镜检查对宫腔病变显示情况，进行对比。计数资料以率、构成比指标进行描述，运用2检验、kappa值等方法进行假设检验。结果： 1.子宫内膜息肉、胚胎残留、粘膜下肌瘤患者在年龄、居住地性质、生育史、流产史、仍有月经方面存在差异；2.子宫内膜息肉、胚胎残留、粘膜下肌瘤患者临床表现均以阴道不规则出血为主；3.在诊断子宫内膜息肉方面，多普勒超声检查结果与病理检查结果一致性较好，但是诊断率较低；宫腔镜检查结果与病理检查结果一致性较差，但是诊断率较高。4.在诊断粘膜下肌瘤方面，多普勒超声检查、宫腔镜检查与病理检查结果一致性均较好，且多普勒超声检查诊断率高于宫腔镜检查。结论： 1.宫腔病变患者以30～50岁年龄段、城市居民、有过生育史和流产史的妇女为主，且子宫内膜息肉、粘膜下肌瘤、胚胎残留在年龄、居住地性质、有过生育史和流产史方面分布不同。2.宫腔占位性病变患者以阴道不规则出血、月经量增多和月经经期延长为主要临床表现。3.阴道多普勒超声检查与病理检查结果具有较好的一致性,可作为首选检查手段。4.对于宫腔占位性病变，阴道多普勒超声检查与临床症状检查均有较好诊断价值，且二者联合诊断价值最佳。
[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.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R711.74

【参考文献】