| Objective:The comparative analysis of the value of simple vaginal ultrasound and hysteroscopy combined with vaginal ultrasound in the diagnosis of endometrial polyps,and summarize the clinical features of patients with endometrial polyps.Methods:A retrospective collection of 414 patients with suspicious endometrial polyps who underwent hysteroscopy for anomalous uterine bleeding due to abnormal uterine bleeding or vaginal ultrasound during the December 2015-December 2017 period at the First Hospital of Shanxi Medical University Clinical records of 390 patients diagnosed with endometrial polyps after postoperative pathological examination were analyzed,including the patient's general condition(age,parity,whether IUD was placed,combined with other diseases),clinical symptoms,ultrasound diagnosis,and Endoscopy combined with vaginal ultrasound diagnosis,postoperative pathological types,etc.Results:1.Age distribution: ranged from 20 to 82 years old,including 1 case(0.26%)less than21 years old,39 cases(10%)aged 21-30,and 90 cases(23.07%)31-40 years old.There were 159(41.7%)cases aged 41-50 years,74 cases(18.97%)aged 51-60 years,26 cases(6.67%)61-70 years old,and 1 case(0.26%)older than 70 years old.2.Marriage and childbirth: 48 cases(12.31%)were not born,and 342 cases(87.69%)were already born.Among them,there were 163 cases(41.80%)with no history ofmiscarriage,117 cases(30.00%)with miscarriage 1,66 cases(16.92%)with miscarriage 2times,and 44 cases(11.28%)with miscarriages >3 times.3.IUD: Intrauterine IUD patients were placed in 17 patients(4.36%).4.Combined diseases: a total of 155 cases,including 62 cases with uterine fibroids(40.00%);13 cases with adenomyosis(8.39%);17 cases with infertility(10.97%);21 cases with cervical polyps(13.55%);34 cases(21.94%)with metabolic diseases(hypertension,diabetes,etc.);8 cases(5.16%)using exogenous hormones(Tremifene and tamoxifen after breast cancer).5.Clinical symptoms: abnormal uterine bleeding in 302 cases(77.44%),of which 176 cases of menstrual changes(45.23%),42 cases of vaginal bleeding(10.80%),34 cases of inter-bleeding(8.79%),contact bleeding Four cases(1.01%),46 cases(11.81%)of postmenopausal bleeding,17 cases(4.27%)of infertility,Asymptomatic only when screened by ultrasound diagnosis 71 cases(18.09%)after postoperative pathology.6.Vaginal ultrasound: diagnosis of 157 cases of endometrial polyps,of which 233 missed diagnosis,misdiagnosis in 7 cases.The diagnostic sensitivity,specificity,false-negative rate,false positive rate,Youden index,and area under ROC curve were40.26%,70.83%,59.74%,29.17%,0.1109,055545,respectively.7.Hysteroscopy combined with vaginal ultrasound: Diagnosis of 340 cases of endometrial polyps,of which 50 were missed,9 cases were misdiagnosed.The area under the diagnostic sensitivity,specificity,false negative rate,false positive rate,Youden index and ROC curve were 87.18%,62.50%,12.28%,37.50%,0.2468,and 0.62340,respectively.8.Pathological types: 42 cases of functional polyps(10.8%);329 cases of non-functional polyps(84.42%),including 306 cases of basal polyps(78.64%),14 cases of polyposis with simple hyperplasia(3.52%),polyps Nine cases(2.26%)were complicated with hyperplasia;19 cases(4.77%)were adenomyoma-like polyps.Conclusion:1.Most patients with endometrial polyps are 41-50 years old;2.The incidence of endometrial polyps may be related to age;3.Endometrial polyps may cause infertility;4.The clinical symptoms of endometrial polyps are most common with AUB;5.The pathological types of endometrial polyps were mostly non-functional EP,which were mostly seen in 41-50-year-old women,and the main one was basal EP.The adenoid fibroids-like EP were mostly found in 51-60-year-old women.6.Transvaginal ultrasound for non-invasive diagnostic methods,can be used as the first choice for the diagnosis of EP,but the high rate of missed diagnosis;hysteroscopy combined with vaginal ultrasound is more accurate,more significant for the diagnosis of EP,the rate of missed diagnosis can be significantly reduced. |
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