阴道镜初学者前200个病例总结及学习曲线分析

发布时间：2019-03-14 07:46

【摘要】：目的评估阴道镜初学者的检查效果,探讨阴道镜的学习曲线。方法回顾性分析2015年3-10月在北京大学第一医院门诊由单一阴道镜初学者独立操作的最初200例患者。分前100例和后100例组,比较阴道镜检查指征、平均检查时间、活检率、宫颈病变检出率和阴道镜拟诊与病理诊断吻合率。结果前100例和后100例组的平均年龄、阴道镜检查指征相比,差异无统计学意义(P0.05)。前100例患者平均检查时间(14.87±3.83)min,后100例患者平均检查时间为(12.05±3.57)min,二者相比差异有统计学意义(P0.05)。前100例患者中低度鳞状上皮内病变(LSIL)以上病变共33例,后100例患者中LSIL以上病变共27例,两者相比差异无统计学意义(P0.05)。前100例组取活检的85例患者中,病理诊断与阴道镜拟诊完全一致者52例(61.2%),后100例组取活检的89例患者中,病理诊断与阴道镜拟诊完全一致者52例(58.4%),两者相比差异无统计学意义(P0.05)。阴道镜检查后有4例患者分别因发热、出血和阴道填纱取出困难就诊,均发生在前100例组。结论随着检查例数的增加,阴道镜初学者检查效率提高,宫颈病变检出率和拟诊吻合率基本稳定。
[Abstract]:Objective to evaluate the effect of colposcopy beginners and explore the learning curve of colposcopy. Methods A retrospective analysis was made of the first 200 patients who were independently operated by a single colposcopy in the first Hospital of Peking University from March to October, 2015. The colposcopy indication, average examination time, biopsy rate, detection rate of cervical lesion and coincidence rate between colposcopy and pathological diagnosis were compared between the groups of 100 cases before and after 100 cases of colposcopy. Results there was no significant difference in the average age and colposcopy indication between the first 100 cases and the latter 100 cases (P0.05). The average examination time of the first 100 patients was (14.87 卤3.83) min, and the average examination time of the 100 patients was (12.05 卤3.57) min, (P0.05). There were 33 cases above (LSIL) in the first 100 cases of low-grade squamous intraepithelial lesions, and 27 cases in the latter 100 cases. There was no significant difference between the two groups (P0.05). Of the 85 cases of biopsy in the first 100 cases, 52 cases (61.2%) were completely consistent with colposcopy, and 52 cases (58.4%) were completely consistent in pathological diagnosis with colposcopy in 89 cases of biopsy in the latter 100 cases, and the pathological diagnosis was consistent with colposcopy in 52 cases (58.4%), and the pathological diagnosis was consistent with colposcopy in 52 cases (58.4%). There was no significant difference between the two groups (P0.05). After colposcopy, 4 patients were diagnosed with fever, bleeding and difficulty in vaginal gauze removal, all of which occurred in the first 100 cases. Conclusion with the increase of the number of examination cases, the efficiency of colposcopy beginner's examination is improved, and the detection rate of cervical lesions and the coincidence rate of suspected diagnosis are basically stable.
【作者单位】：北京大学第一医院妇产科;
【分类号】：R711

【参考文献】