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目的评估阴道镜初学者的检查效果,探讨阴道镜的学习曲线。方法回顾性分析2015年3-10月在北京大学第一医院门诊由单一阴道镜初学者独立操作的最初200例患者。分前100例和后100例组,比较阴道镜检查指征、平均检查时间、活检率、宫颈病变检出率和阴道镜拟诊与病理诊断吻合率。结果前100例和后100例组的平均年龄、阴道镜检查指征相比,差异无统计学意义(P>0.05)。前100例患者平均检查时间(14.87±3.83)min,后100例患者平均检查时间为(12.05±3.57)min,二者相比差异有统计学意义(P<0.05)。前100例患者中低度鳞状上皮内病变(LSIL)以上病变共33例,后100例患者中LSIL以上病变共27例,两者相比差异无统计学意义(P>0.05)。前100例组取活检的85例患者中,病理诊断与阴道镜拟诊完全一致者52例(61.2%),后100例组取活检的89例患者中,病理诊断与阴道镜拟诊完全一致者52例(58.4%),两者相比差异无统计学意义(P>0.05)。阴道镜检查后有4例患者分别因发热、出血和阴道填纱取出困难就诊,均发生在前100例组。结论随着检查例数的增加,阴道镜初学者检查效率提高,宫颈病变检出率和拟诊吻合率基本稳定。
Objective To evaluate the examination results of colposcopy beginners and explore the learning curve of colposcopy. Methods A retrospective analysis of the first 200 patients who were independently operated by a single colposcopy beginner at Peking University First Hospital from March 2015 to October 2015 was performed. 100 cases in the former and 100 cases in the latter group. The colposcopic examination indications, the average examination time, the biopsy rate, the detection rate of cervical lesions and colposcopy diagnosis and pathological diagnosis were compared. Results There was no significant difference in the mean age between the first 100 cases and the last 100 cases after colposcopy examination (P> 0.05). The average time of the first 100 patients (14.87 ± 3.83) min and the last 100 patients (12.05 ± 3.57) min, the difference was statistically significant (P <0.05). The first 100 cases of low grade squamous intraepithelial lesion (LSIL) more than 33 cases of lesions, the latter 100 cases of LSIL lesions in a total of 27 cases, the difference was not statistically significant (P> 0.05). Of the 85 patients who underwent biopsy in the first 100 cases, 52 (61.2%) were pathologically diagnosed as being completely consistent with colposcopy and the other 100 were biopsies. Of the 89 patients who underwent biopsy, the pathological diagnosis was completely consistent with colposcopy 52 cases (58.4%), no significant difference between the two groups (P> 0.05). Four patients after colposcopy were diagnosed by fever, hemorrhage and vaginal filling, respectively. All occurred in the first 100 cases. Conclusion With the increase of the number of examinations, colposcopy beginners examination efficiency increased, cervical lesions detection rate and the proposed anastomosis was basically stable.