经阴道三维彩超诊断子宫内膜息肉样病变的应用价值探讨

郑汉能 方建华 柳画云

[摘要] 目的 探讨经阴道三维彩超（TCDU）诊断子宫内膜息肉样病变的应用价值。方法 方便选取该院于2014年5月—2018年5月收治的子宮内膜息肉样病变患者100例作为研究对象，随机分为两组。对照组采用常规检查方式诊断患者子宫内膜息肉样病变，研究组采用阴道三维彩超诊断，以病理检查作为诊断的金标准，对比两种检查方式诊断患者子宫内膜息肉样病变的情况。结果 经研究组方式检查子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤以及子宫内膜癌的符合率82.0%均显著高于经对照组检查的符合率54.0%，差异有统计学意义（χ2=5.989，P<0.05）;研究组检查的诊断性试验指标的统计学结果，敏感性、准确性、特异性、阳性预测值、阴性预测值、灵敏度、诊断指数（90.0%、95.0%、95.0%、90.0 %、95.0%、90.0%、191.94）明显高于对照组（65.0%、60.0%、80.0%、70.0%、80.0%、65.0%、189.57）同时漏诊率（18.0%）低于对照组（46.0%），差异有统计学意义（χ2=5.138、5.226、4.381、4.029、4.002、5.019、4.103、5.942，P<0.05）。结论 经阴道三维彩超（TCDU）诊断患者子宫内膜息肉样病变的效果显著，比常规检查方式有更多明显优势，疾病检出率、准确率以及应用价值高，是临床诊断子宫内膜息肉样病变的最有效方式，值得在临床上进一步推广应用。

[关键词] 阴道三维彩超;诊断;子宫内膜息肉样病变;应用价值

[中图分类号] R711.74          [文献标识码] A          [文章编号] 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.