Clinical value of hysteroscopy combined with transvaginal ultrasound in differential diagnosis of abnormal uterine bleeding / 中国基层医药

ABSTRACT

Objective:To observe the clinical value of hysteroscopy combined with transvaginal ultrasound in the differential diagnosis of different causes of abnormal uterine bleeding(AUB).Methods:From September 2017 to September 2019, 260 patients with AUB who were treated in Zhuji People's Hospital were selected in the study.All patients had histopathological examination results, which was the gold standard.At the same time, hysteroscopy, transvaginal ultrasound and the combined detection were performed.The diagnostic value of each test method for different etiology of AUB was compared.Results:The coincidence rate of hysteroscopy combined with transvaginal ultrasound(96.54%) in the overall identification of AUB of different causes was significantly higher than that of hysteroscopy (84.6%) and transvaginal ultrasound (70.77%) (χ 2=21.653, 63.131; P=0.000, 0.000); while the missed detection rate and misdiagnosis rate (2.69%, 0.77%) were significantly lower than those of hysteroscopy (10.38%, 5.00%) and transvaginal ultrasound (19.32%, 10.00%) (χ 2=12.588, 8.306, 36.432, 21.742; P=0.000, 0.004, 0.000, 0.000). The diagnostic sensitivity and accuracy of combined detection for organic AUB (97.00%, 96.54%) were significantly higher than those of hysteroscopy (88.41%, 87.31%) and transvaginal ultrasound alone (78.54%, 76.54%), and the diagnostic specificity of combined detection for organic AUB (92.59%) was significantly higher than that of transvaginal ultrasound (59.26%), the differences were statistically significant(χ 2=12.691, 14.919, 36.959, 44.637, 8.206; P=0.000, 0.000, 0.000, 0.000, 0.004). Conclusion:Hysteroscopy combined with transvaginal ultrasound can improve the efficiency of differential diagnosis of AUB.