经阴道超声及宫腔镜诊断不孕不育病人宫腔异常的价值

程炳辉; 周秀芬; 罗骥

doi:10.13898/j.cnki.issn.1000-2200.2022.07.020

经阴道超声及宫腔镜诊断不孕不育病人宫腔异常的价值

Clinical value of transvaginal sonography and hysteroscopy in the diagnosis of uterine abnormalities in infertility patients

摘要

摘要:
目的探讨经阴道超声(TVS)及宫腔镜诊断不孕不育病人宫腔异常的临床应用价值。
方法选取90例均行TVS及宫腔镜检查，以宫腔镜结果为金标准评价TVS诊断不孕不育病人宫腔异常的效能，统计宫腔异常病人疾病类型，分析TVS诊断不同疾病类型宫腔异常病人的结果。
结果90例病人中包括宫腔异常病人86例，TVS诊断不孕不育病人宫腔异常的效能的敏感性为95.35%，特异性为75.00%，阳性预测值为98.80%，阴性预测值为57.14%，TVS诊断宫腔异常的准确性为94.44%，与宫腔镜结果差异均无统计学意义(P>0.05)；宫腔异常病人中包括黏膜下肌瘤35例，宫腔息肉29例，宫腔粘连21例，子宫畸形1例；TVS诊断黏膜下肌瘤敏感性为85.71%，特异性为90.91%，阳性预测值为85.71%，阴性预测值为90.91%；TVS诊断宫腔息肉的敏感性为82.76%，特异性为95.08%，阳性预测值为88.89%，阴性预测值为92.06%；TVS诊断宫腔粘连的敏感性为76.19%，特异性为89.86%，阳性预测值为69.57%，阴性预测值为92.54%；TVS诊断子宫畸形的结果与宫腔镜结果相符。
结论TVS诊断宫腔异常病例准确性较高，可为医师判断病人宫腔异常疾病类型提供参照，具有重要的临床应用价值。

Abstract:
ObjectiveTo explore the clinical value of transvaginal sonography(TVS) and hysteroscopy in the diagnosis of uterine abnormalities in infertiity patients.
MethodsNinety infertility patients were examined using TVS and hysteroscopy.The hysteroscopic results were used as the gold standard to evaluate the efficacy of TVS in the diagnosis of uterine cavity abnormalities in infertility patients, the disease types of patients with uterine cavity abnormalities were counted, and the results of TVS in the diagnosis of different types of diseases were analyzed.
ResultsAmong 90 infertility patients, 86 patients with uterine anomalies were found.The sensitivity, specificity, positive predictive value and negative predictive value of the effectiveness of TVS in diagnosing uterine abnormalities were 95.35%, 75.00%, 98.80% and 57.14%, respectively.The accuracy of TVS in diagnosing uterine cavity abnormalities was 94.44%, and there was no statistical significance between TVS and hysteroscopy(P>0.05).Among the patients with abnormal uterine cavity, there were 35 cases of submucosal fibroids, 29 cases of intrauterine polyps, 21 cases of intrauterine adhesions and 1 case of uterine malformation.The sensitivity, specificity, positive predictive value and negative predictive value of TVS in the diagnosis of submucosal myoma were 85.71%, 90.91%, 85.71% and 90.91%, respectively.The sensitivity, specificity, positive predictive value and negative predictive value of TVS in the diagnosis of uterine polys were 82.76%, 95.08%, 88.89% and 92.06%, respectively.The sensitivity, specificity, positive predictive value and negative predictive value of TVS in the diagnosis of intrauterine adhesions were 76.19%, 89.86%, 69.57% and 92.54%, respectively.The TVS diagnosis of uterine malformation was consistent with the hysteroscopic results.
ConclusionsTVS has a high accuracy in diagnosing uterine abnormalities in infertility patients, which can provide a reference for doctors to judge the types of uterine abnormalities, and has important clinical application value.

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