阴道超声联合宫腔镜在子宫出血中的诊断价值

目的探讨阴道超声联合宫腔镜诊断子宫出血的临床价值。方法选择本院2009年7月～2011年10月收治的120例子宫出血患者为研究对象,采用随机数字表法将所有患者分为对照组和观察组,对照组患者采用阴道超声检查辅助子宫出血的诊断,观察组患者则接受阴道超声联合宫腔镜检查,以病理诊断结果为金标准,比较两种检查手段的灵敏度和阳性预测值。结果腹部超声检查的灵敏度为48.78%,阴道超声联合宫腔镜检查的灵敏度为90.24%,差异有统计学意义（P〈0.05）;腹部超声检查的阳性预测值为64.52%,阴道超声联合宫腔镜检查的阳性预测值为97.37%,差异有统计学意义（P〈0.05）。结论阴道超声联合宫腔镜诊断子宫出血灵敏度及阳性预测值更高,漏诊情况少见,结果更加接近于病理诊断结果,对子宫出血的诊断具有重要价值。

The diagnostic value of uterine bleeding by transvaginal ultrasonography combined with hysteroscopy

Objective To investigate the diagnostic value of uterine bleeding by transvaginal ultrasonography combined with hysteroscopy. Methods 120 cases of patients with uterine bleeding who were treated in our hospital from July 2009 to October 2011 were selected as research object,then they were divided into control group and observation group by random number table, the patients in control group were given transvaginal sonography for the diagnosis of uterine bleeding, while the patients in observation group were given transvaginal ultrasonography combined with hysteroscopy for the diagnosis of uterine bleeding.Took the pathological diagnosis results as the gold standard.The sensitivity and positive predictive value of two groups was evaluated. Results The sensitivity of transvaginal sonography was 48.78%, the sensitivity of transvaginal ultrasonography combined with hysteroscopy was 90.24%,the differences was statistically significant（P 0.05）; the positive predictive value of transvaginal sonography was 64.52%,while the positive predictive value of transvaginal ultrasonography combined with hysteroscopy was 97.37%, the differences was statistically significant （P 0.05）. Conclusion The sensitivity and positive predictive value of transvaginal ultrasonography combined with hysteroscopy is high, the missing rate is a rare,its results is more close to the pathological diagnosis, and it is of important value to the diagnosis of uterine bleeding.