阴道超声及宫腔镜在不育患者宫腔异常诊断中的应用评价

发布时间：2018-03-04 19:37

本文选题：经阴道超声　切入点：宫腔镜　出处：《重庆医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的评估经阴道超声(transvaginal sonography，TVS)及宫腔镜诊断不孕不育患者宫腔异常的临床应用价值。方法回顾性分析324例不孕不育患者TVS的及宫腔镜检查结果，以宫腔镜结果作为金标准，计算经阴道超声诊断宫腔异常的ROC曲线下面积(area under the ROC curve,AUC)、阳性似然比（positive likelihoodratios,LR+)、阴性似然比(negative likelihood ratios,LR-)、敏感度、特异度、阳性预测值（positive predictive value,PPV）和阴性预测值（negativepredictive value,NPV)。结果TVS诊断宫腔异常的AUC为0.811、LR+为2.87、LR-为0.07、敏感度为95.5%、特异性度66.7%、阳性预测值为98.7%、阴性预测值为36.4%；其中TVS诊断宫腔粘连的宫腔粘连的AUC为0.880、LR+为10.38、LR-为0.17、敏感度为84.1%、特异度为91.9%、阳性预测值为86.9%、阴性预测值为90.0%；TVS诊断子宫内膜炎的AUC为0.821、LR+为7.23、LR-为0.28、敏感度为74.5%、特异度为89.7%、阳性预测值为78.8%、阴性预测值为87.3%；TVS诊断子宫内膜息肉的AUC为0.893、LR+为17.35、LR-为0.18、敏感度为83.3%、特异度为95.2%、阳性预测值为83.3%、阴性预测值为95.2%。结论经阴道超声可了解子宫形态及宫腔内异常情况，具有安全无创、有效、操作简单、可重复性强等特点，可作为诊断宫腔异常的筛查方法。宫腔镜对慢性子宫内膜炎的诊断具有确诊意义。
[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.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.6

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