經陰道三維彩超診斷子宮內膜息肉樣病變的應用價值探討

鄭漢能 方建華 柳畫云

[摘要] 目的 探討經陰道三維彩超（TCDU）診斷子宮內膜息肉樣病變的應用價值。方法 方便選取該院于2014年5月—2018年5月收治的子宮內膜息肉樣病變患者100例作為研究對象，隨機分為兩組。對照組采用常規檢查方式診斷患者子宮內膜息肉樣病變，研究組采用陰道三維彩超診斷，以病理檢查作為診斷的金標準，對比兩種檢查方式診斷患者子宮內膜息肉樣病變的情況。結果 經研究組方式檢查子宮內膜增生、子宮內膜息肉、子宮黏膜下肌瘤以及子宮內膜癌的符合率82.0%均顯著高于經對照組檢查的符合率54.0%，差異有統計學意義（χ2=5.989，P<0.05）;研究組檢查的診斷性試驗指標的統計學結果，敏感性、準確性、特異性、陽性預測值、陰性預測值、靈敏度、診斷指數（90.0%、95.0%、95.0%、90.0 %、95.0%、90.0%、191.94）明顯高于對照組（65.0%、60.0%、80.0%、70.0%、80.0%、65.0%、189.57）同時漏診率（18.0%）低于對照組（46.0%），差異有統計學意義（χ2=5.138、5.226、4.381、4.029、4.002、5.019、4.103、5.942，P<0.05）。結論 經陰道三維彩超（TCDU）診斷患者子宮內膜息肉樣病變的效果顯著，比常規檢查方式有更多明顯優勢，疾病檢出率、準確率以及應用價值高，是臨床診斷子宮內膜息肉樣病變的最有效方式，值得在臨床上進一步推廣應用。

[關鍵詞] 陰道三維彩超;診斷;子宮內膜息肉樣病變;應用價值

[中圖分類號] R711.74? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）06（b）-0017-04

[Abstract] Objective To investigate the value of transvaginal three-dimensional color Doppler ultrasound （TCDU） in the diagnosis of endometrial polypoid lesions. Methods One hundred patients with endometrial polypoid lesions admitted to our hospital from May 2014 to May 2018 were convenient randomly divided into two groups. The control group was diagnosed with endometrial polypoid lesions by routine examination. The study group used vaginal three-dimensional color Doppler ultrasound diagnosis. Pathological examination was used as the gold standard for diagnosis. The two methods were used to diagnose the endometrial polypoid lesions. Results The coincidence rate of endometrial hyperplasia， endometrial polyps， uterine submucosal fibroids and endometrial cancer was significantly higher than that of the control group by 54.0%. The difference was statistically significant （χ2=5.989， P<0.05）; statistical results of diagnostic test indicators examined by the study group， sensitivity， accuracy， specificity， positive predictive value， negative predictive value， sensitivity， diagnostic index （90.0%， 95.0%， 95.0%， 90.0%， 95.0%， 90.0%， 191.94） significantly higher than the control group （65.0%， 60.0%， 80.0%， 70.0%， 80.0%， 65.0%， 189.57） while the missed diagnosis rate （18.0%） was lower than the control group （46.0%）， the differences were statistically significant （χ2=5.138， 5.226， 4.381， 4.029， 4.002， 5.019， 4.103， 5.942， P<0.05）. Conclusion Transvaginal three-dimensional color Doppler ultrasound （TCDU） is effective in the diagnosis of endometrial polypoid lesions. It has more obvious advantages than conventional examination methods. The disease detection rate， accuracy and application value are high. It is a clinical diagnosis of endometrial polypoid. The most effective way of pathology is worth further clinical application.