阴道超声联合子宫输卵管造影对剖宫产子宫切口缺陷的诊断价值

目的 探讨阴道超声（TVU）与子宫输卵管造影（HSG）联合应用对诊断剖宫产子宫切口缺陷（PCSD）的临床实用价值.方法 42例因剖宫产术后阴道异常出血、痛经或不孕患者行TVU、HSG及宫腔镜检查,将单纯TVU、HSG或TVU联合HSG检查结果与宫腔镜检查结果进行比较分析.结果 42例患者中21例经宫腔镜检查确诊为PCSD.单纯TVU检查敏感度66.7％（14/21）,特异度95.2％（20/21）,阳性预测值14/15,阴性预测值74.1％（20/27）;单纯HSG检查敏感度95.2％（20/21）,特异度100.0％（21/21）,阳性预测值100.0％（20/20）,阴性预测值95.5％（21/22）.TVU联合HSG检查诊断敏感度为95.2％（20/21）,与单纯TVU检查相比,TVU联合HSG检查敏感度显著提高,差异有统计学意义（P＜0.05）.结论 TVU联合HSG诊断PCSD相比单纯TVU检查敏感度更高,可考虑推广用于PCSD的诊断.

The diagnosis value of transvaginal ultrasound combined with hysterosalpinography on previous cesarean scar defect

Objective To investigate the clinical practice value of transvaginal ultrasound （TVU） combined with hysterosalpinography （HSG） in diagnosis of previous cesarean scar defect （PCSD）.Methods Forty-two patients with colporrhagia,algomenorrhea or infertility after cesarean section were examined by TVU,HSG and hysteroscope.The results were compared among TVU,HSG and TVU combined with HSG.Results Among the 42 patients,21 patients were diagnosed PCSD by hysteroscope.The sensitivity of TVU was 66.7% （14/21）,specificity was 95.2% （20/21）,positive predictive value was 14/15,negative predictive value was 74.1% （20/27）.The sensitivity of HSG was 95.2% （20/21）,specificity was 100.0% （21/21）,positive predictive value was 100.0%（20/20）,negative predictive value was 95.5%（21/22）.The sensitivity of TVU combined with HSG was 95.2%（20/21）,the sensitivity of TVU combined with HSG was significantly higher than TVU,there was statistical difference （P 〈0.05）.Conclusions Compared with TVU,the sensitivity of TVU combined with HSG is increased markedly.TVU combined with HSG is a feasible clinical diagnostic method.