论著

广州市围绝经期女性绝经综合征的相关危险因素分析

Relevantrisk factors of urban women's perimenopause symptoms in Guangzhou

:97-103
 
目的 了解城市围绝经期妇女绝经综合征的发生现状及分析相关影响因素,为进一步加强围绝经期妇女的保健工作提供理论依据。方法 纳入2019年2月—2020年2月就诊于广州市妇女儿童医疗中心中西医妇科门诊、天河及越秀区某社区的40~60岁女性共1 013名,采用问卷调查及Kupperman评分表收集出生日期,月经情况(初潮、绝经年龄等),孕产史,既往疾病史,身高、体质量,工作性质、家庭收入及个性等特征。结果 1 013例妇女的平均年龄是(47.70±4.95)岁,已绝经267例,未绝经女性中月经规律458例、月经紊乱288例,平均绝经年龄(49.49±3.26)岁。Kupperman评分超过15分(即诊断为绝经综合征)392 例(38.7%),其中轻度(15~20分) 222例(56.63%),中度(21~35分)162例(41.33%),重度(>35分)8例(2.04%)。多因素Logistic 回归分析表明,有慢性疾病较无慢性疾病史,月经紊乱、绝经较月经规律,家庭情况一般较和睦女性出现围绝经期症状风险升高,未观察到婚姻状况、个性特征、上班时长、社会适应、负性事件经历与围绝经期症状的出现相关。结论 广州城市存在绝经综合征的女性以轻中度为主,有慢性疾病、月经紊乱、绝经、家庭关系一般女性的绝经综合征发生风险较高,故应重视对全社会进行围绝经相关知识的宣教,重视家庭关系的和谐维护,当围绝经期妇女出现相关症状须及时寻求帮助,以保障广大围绝经期妇女顺利度过围绝经期阶段。
Objective To investigate the menopause symptoms and factors of the premenopausal women in urban areas, and thereby provide theoretical basis for their health care. Methods The research data was collected from 1 013 patients (age between 40-60) in the gynecology clinic and adult traditional Chinese medicine clinic in Guangzhou Women and Children's Medical Center, and the communities in Tian'he and Yue'xiu during February 2019—February 2020. By applying the questionnaire and Kupperman score table, the survey was conducted on the dates of birth, menstruations, times of menarche and menopause, records on pregnancy and childbirth, previously diagnosed diseases, heights, weights, classifications of work, family incomes, and personalities, etc. Results The average age of the 1 013 women was 47.70±4.95. Among them, 267 were with menopause (happening in 49.49±3.26 years old), 458 had regular menstruation, while 288 were with menstrual disorder. In the Kupperman scale, the scores of 392 cases (38.7%) were above 15, which can be diagnosed with menopause symptoms. Among them, the majority (222 cases, 56.63%) were with slight symptoms (15-20 scores), followed by 162 cases (41.33%) with moderate symptoms (21-35 scores), and 8 cases (2.04%) with severe symptoms (above 35 scores) respectively. Logistic regression analysis demonstrated that compared with women having satisfactory family relationship, participants suffering from chronic diseases, menstrual disorder, and poor family relationships, had higher risks of perimenopause. However, it had no relations with the marital status, personalities, working hours, social adaptabilities, and negative life events. Conclusion Guangzhou urban women with menopause symptoms are mainly slight and moderate. Participants with chronic diseases, menstrual disorders and poor family relationships are at a higher risk of having menopause symptoms. Therefore, it is recommended to popularize the knowledge of menopause in the society and attach importance to the maintenance of satisfactory family relationship. When perimenopausal women have relevant symptoms, they should seek medical help in time thus they can smoothly pass the peri-menopausal stage.
论著

不同职业人群前列腺疾病患病率及影响因素分析

Analysis on the prevalence of prostate disease and its influencing factors in different occupational populations

:92-96
 
目的 通过对不同职业人群前列腺疾病患病情况及相关危险因素进行分析,探讨不同职业人群前列腺疾病的患病率及相关危险因素。方法 选择2019年1月—2019年12月在我院健康管理中心进行前列腺超声检查的不同职业人群3 219例,按其职业分为5类:医务人员、国企职工、私企职工、高校教职工和银行职工,分析不同职业人群前列腺疾病患病情况及其相关影响因素。结果 3 219例受检者中,前列腺疾病的患病率为43.96%,前列腺疾病患病率随着年龄的增长而升高(P<0.001);20~29岁及30~39岁年龄组前列腺钙化患病率均高于其他三种类型前列腺疾病(P<0.001),而60岁以上年龄组前列腺增生和合并两种及以上前列腺疾病患病率均高于其他两种类型前列腺疾病(P<0.001);前列腺增生和合并两种及以上前列腺疾病的患病率均随着年龄的增长而递增(P<0.001);不同职业人群前列腺疾病的患病率不同(P<0.001),银行职工的前列腺疾病患病率最高,为52.36%;体质量指数升高组、血压升高组和血脂升高组的前列腺钙化患病率均高于其对应的正常组(P<0.05);体质量指数升高组、血糖升高组、血压升高组和血脂升高组的前列腺增生患病率均高于其对应的正常组(P<0.001)。结论 不同的职业群体前列腺疾病的患病情况不一样,体质量指数升高、血压升高、血脂升高及血糖升高等相关因素增加患前列腺疾病的风险,应加强前列腺疾病预防保健方面的健康宣传,提倡健康的生活方式,从而降低前列腺疾病的患病率。
Objective To study on epidemic situation of prostate disease and related risk factors in different occupational groups by analyzing the prevalence and related risk factors of prostate disease in different occupational groups. Methods 3 219 cases of five different occupations including medical staffs, state-owned enterprise staffs, private enterprise staffs,college staffs and bank staffs who had underwent prostate ultrasonography in the health management centre department of the Fifth Affiliated Hospital of Guangzhou Medical University from January 2019 to December 2019 were included as study objects to analyze the prevalence of prostate disease and its related factors in different occupational groups. Results The prevalence of prostate disease was 43.96% in 3 219 cases of different occupational groups, and the prevalence of prostate disease increased greatly with age(P<0.001). The detection rates of prostate calcification in the age group of 20-29 and 30-39 were greatly higher than the other three types of prostate diseases(P<0.001). The detection rate of BPH and with two or more prostate diseases in the age group over 60 years old was greatly higher than the other two types of prostate diseases(P<0.001);The detection rates of BPH and with two or more prostate diseases were significantly increased with age (P<0.001). There was an obvious difference inthe prevalence of prostate diseasesamong different occupational groups(P<0.001). The prevalence of prostate disease in bank staffs was 52.36%, which was the highest among the five occupations. The prevalence of prostate calcification in the group with high body mass index, high blood pressure and high blood lipid were greatly higher than that of their normal group(P<0.05). The prevalence of BPH in the group with high body mass index, high blood glucose, high blood pressure and high blood lipid were higher than that of their greatly normal group(P<0.001). Conclusions The prevalence of prostate diseases is different among different occupational groups. Relative factors such as high body mass index, high blood glucose, high blood pressure and high blood lipid will increase the risk of prostate disease. By strengthening the health promotion of prostate disease prevention and health care, promoting a healthy lifestyle, it may reduce the prevalence of prostate disease.
论著

胰腺实性假乳头状肿瘤病例报告并文献复习

Solid pseudopapillary tumor of the pancreas: a case report and literature review

:88-91
 
目的 报道1例中年女性胰腺实性假乳头状肿瘤病例,并通过文献回顾和复习,提高临床医生对此类罕见病的认识,减少该疾病的误诊、漏诊。方法 回顾性分析1例中年女性胰腺实性假乳头状肿瘤的诊治经过,结合以往的文献报道,总结该疾病的临床表现、诊治方法。结果 回顾文献显示:胰腺实性假乳头状肿瘤比较罕见,好发于年轻女性,属于低度恶性肿瘤。本例患者38岁女性,因腹痛入院。术后病理证实为胰腺实性假乳头状肿瘤。随访1年,未见明显复发和转移征象。结论 胰腺实性假乳头状肿瘤临床表现无特异性,诊断主要依靠影像学检查和组织病理学结果。手术切除是胰腺实性假乳头状肿瘤首选治疗手段。
Objective To report a case of solid pseudopapillary tumor of the pancreas and review literatures about this disease, so as to improve clinical understanding of this rare disease and reduce misdiagnosis and missed diagnosis. Methods The clinical manifestation,diagnosis and treatment of the patient with solid pseudopapillary tumor of the pancreas were analyzed retrospectively. The clinical manifestation and key points of diagnosis were summarized from literature review. Results Literature review showed that: solid pseudopapillary tumor of the pancreas is a rare low-grade malignancy tumors, which frequently occurs in young women. This case is a thirty-eight years old female patient who was admitted to the hospital due to abdominal pain. Postoperative pathology confirmed a solid pseudopapillary tumor of the pancreas. Follow-up of 1 year showed no obvious signs of recurrence and metastasis. Conclusion Solid pseudopapillary tumor of the pancreas has no specific clinical manifestations, the diagnosis mainly depends on imaging examination and histopathological results. Surgical resection is the preferred treatment for solid pseudopapillary tumors of the pancreas.
论著

广州市区无偿献血人群乳糜血报废调查分析

Analysis of scrapped chylemia blood of voluntary blood donors in Guangzhou urban area

:84-87
 
目的 了解广州市区全血乳糜血报废的趋势变化和献血人群特征,并分析其背后的原因,为进一步减少全血乳糜血报废提供参考依据。方法 通过广州血液中心信息系统检索,统计2017—2019年期间中心全血乳糜血报废量、报废率等相关数据,并分层统计性别、年龄、献血方式与报废的关系,提出有效减少乳糜血报废的对策。结果 2017—2019年期间广州血液中心共采集制备3 003 998单位血液,因乳糜血原因报废的血液达69 311单位,报废率2.31%,占总报废的44.02%。其中,男性献血者乳糜血报废率显著高于女性献血者,报废血液主要为18~40岁年龄段的无偿献血,约一半报废血来自团体献血者。结论 加大献血知识的宣传,特别是团体献血者;做细献血前征询工作和献血后跟踪随访;关注男性和年轻献血者,进一步减少全血乳糜血报废几率。
Objective To evaluate the trend of scrapped chylemia blood in whole blood collection and the characteristics of blood donors in urban area of Guangzhou, analyze the reasons behind so as to provide reference for further reducing chylemia blood scrapped. Methods Search the whole blood collection and scrapped chylemia blood data from 2017 to 2019 through the information system of Guangzhou Blood Center, stratifiy gender,age,donation way, and look for solutions. Results 3 003 998 U blood component were collected and prepared from 2017 to 2019. Totally 69 311 U chylemia blood were scrapped due to chylemia blood, accounting for 44.02% of the total discarded blood. Scrapped chylemia blood rate were significantly higher among male blood donors than among female donors,and mainly aged from 18-40 donors. About half of the discarded blood came from group donors. Conclusion Greater efforts to publicize especially for group donors,careful consultation before blood donation and follow-up after blood donation should be taken. We should pay close attention to male and young blood donors, so as to further reduce the possibility of scrapped chylemia blood.
论著

无痛镇静在胃镜下上消化道异物取出术中的应用研究

The study of application value of painless gastroscope in the removal of foreign body in upper gastrointestinal tract

:74-78
 
目的 探讨无痛镇静在胃镜下上消化道异物取出术中的应用价值。方法 回顾分析2017年5月1日—2020年5月1日在东莞东华医院消化内镜中心接受内镜下上消化道异物取出术患者,对其临床资料进行分析,总结比较在无痛镇静下和普通胃镜下上消化道异物取出术两组患者的诊疗效果。结果 共357例患者,行胃镜下异物取出术共372次,其中无痛镇静组99例,普通组273例,其中15例患者在普通胃镜下异物取出术失败改为无痛镇静下胃镜取出术成功取出,最终10人异物未取出转外科或上级医院;在无痛镇静下行胃镜上消化道异物取出术比普通胃镜下异物取出术成功率高(P<0.05),黏膜损伤、出血、穿孔等并发症少(P<0.05),人均费用低(P<0.05);无痛镇静后患者血氧饱和度、血压下降(P<0.05),心率升高(P<0.05),其中老年人影响明显(P<0.05),但不影响患者内镜操作,氟马西尼催醒后心率、血氧饱和度、血压恢复正常(P>0.05)。结论 在无痛镇静下行胃镜上消化道异物取术安全、有效、成功率高、医疗费用少,患者易于接受的好方法,值得推广。
Objective To explore the application value of painless gastroscope in the removal of foreign body in upper gastrointestinal tract. Methods The study involved patients who visited at the department of endoscopy center at Hospital (Dongguan, China). Retrospective analysis of patients undergoing endoscopic removal of foreign bodies in the upper gastrointestinal tract from May 1, 2017 to May 1, 2020. We analyzed the patients' clinical data and compared the diagnosis and treatment effect between the painless gastroscope group and normal gastroscopy group. Results A total of 357 patients were included, 372 times of removal of foreign body under gastroscope were conducted. A total of 99 cases in painless gastroscope group were treated by painless gastroscope with painless sedation, 273 cases in normal gastroscopy group were treated by normal gastroscopy, among them, 15 cases were failed to removal the foreign body treated by normal gastroscopy, and turned into the painless sedation gastroscopy. Finally, 10 patients with foreign bodies were not removed and transferred to surgical department or higher level hospitals. In the treatment of endoscopic foreign body removal, the success rate of painless gastroscope group was higher (P<0.05), the complication incidence of mucosal injury, bleeding and perforation and cost per capita were lower than that of normal gastroscopy(P<0.05). Following painless sedation, the blood oxygen saturation, blood pressure dropped (P<0.05) and heart rate increased (P<0.05), the effect of the sedatives on the elderly was the most obvious (P<0.05), but it did not affect the patient's endoscopic operation, and the heart rate, blood oxygen saturation and blood pressure (P>0.05) after awakening. Conclusion Painless gastroscope in the removal of foreign body in upper gastrointestinal tract is safe, effective high success rate, less medical cost, and easy for patients to accept, it should be widely applied.
论著

品管圈活动在降低肠内营养相关性腹泻发生率中的应用

Application of quality control circle activity in reducing the incidence of enteral nutrition-related diarrhea

:71-73
 
目的 探讨品管圈活动在降低使用肠内营养制剂患者肠内营养相关性腹泻发生率的应用效果。方法 由全科医学科的11名护士组成品管圈小组,按品管圈实施步骤首先确定“降低使用肠内营养制剂患者肠内营养相关性腹泻的发生率”为活动主题,对肠内营养患者发生腹泻的情况和护士对肠内营养相关性腹泻认知情况进行现状调查,分析引起肠内营养相关性腹泻的原因,制定并实施相应的整改措施。结果 开展品管圈活动后使用肠内营养制剂腹泻率由原来的50%降低到21.03%,两者差异有统计学意义(χ2=24.859,P<0.001)。将肠内营养制剂加温到38 ℃~40 ℃输注的腹泻率为28.10%,在常温下20 ℃~29 ℃输注的腹泻率为14.5%,两者差异有统计学意义(χ2=7,P<0.05),达到了目标值;开展品管圈后圈能力较开展前高,差异有统计学意义(P<0.05)。结论 开展品管圈活动可有效降低使用肠内营养制剂患者相关性腹泻的发生率,同时增强护理人员质量管理能力。
Objective To investigate the efficacy of quality control circle(QCC) activities in reducing the incidence of enteral nutrition-related diarrhea in patients using enteral nutritionpreparations. Methods According to the QCC's steps, 11 nurses from general medicine department participated in the QCC group first determined the theme as:Reduce the incidence of enteral nutrition preparations correlated diarrhea in patients with enteral nutrition.The situation of diarrhea in patients with enteral nutrition and the cognition of nurses on enteral nutrition-related diarrhea were investigated, the causes of enteral nutrition-related diarrhea were analyzed, and corresponding corrective measures were formulated and implemented. Results After carrying out the QCC program, the incidence rate of enteral nutrition preparation-associated diarrhea decreased from 50% to 21.03%, the result indicated statistical significance(χ2=24.859,P<0.001). The diarrheal rate for warmed enteral nutrition preparations at 38℃-40℃ was 28.10%, and for those under room temperature at 20℃-29℃ was 14.5%, the result of these two groups indicated statistical significance (χ2=7,P<0.05),target number was achieved. The ability of quality control for the nurses are improved compared to that before QCC activity, noted statistical significance (P<0.05). Conclusion QCC activity has effectively reduced the incidence of diarrhea in patients who use enteral nutrition preparations as well as enhance the management ability of nurses in providing quality care.
论著

血常规、血沉、C-反应蛋白水平对小儿急性肺炎的诊断价值分析

Analysis of the diagnostic value of blood routine, erythrocyte sedimentation rate and C-reactive protein level in children with acute pneumonia

:68-70
 
目的 探讨血常规、血沉、C-反应蛋白水平对小儿急性肺炎的诊断价值。方法 选取2014年1月—2019年12月我院收治的小儿急性肺炎100例作为研究组,同时根据有无发生感染将其分为感染组(26例)与非感染组(74例),另外选择同期在我院检查的健康儿童100例作为对照组。比较感染组与非感染组血常规、血沉、C-反应蛋白水平、感染组与对照组血常规、血沉、C-反应蛋白水平、非感染组与对照组血常规、血沉、C-反应蛋白水平。结果 感染组中性粒细胞百分比、白细胞计数、C-反应蛋白高于非感染组(P<0.05),两组血沉对比,无明显差异(P>0.05);感染组中性粒细胞百分比、白细胞计数、C-反应蛋白、血沉高于对照组(P<0.05);两组中性粒细胞百分比、C-反应蛋白水平相比,无明显差异(P>0.05),非感染组白细胞计数、血沉高于对照组(P<0.05)。结论 小儿急性肺炎的诊断中,对小儿的血常规、血沉、C-反应蛋白水平进行检测对诊断疾病非常重要,值得临床使用。
Objective To investigate the diagnostic value of blood routine, erythrocyte sedimentation rate and C-reactive protein level in children with acute pneumonia. Methods A total of 100 cases of acute pneumonia in children admitted to our hospital from January 2014 to December 2019 were selected as the study group. At the same time, they were divided into an infected group (26 cases) and a non-infected group (74 cases) according to the presence or absence of infection. In addition, 100 healthy children examined in our hospital during the same period were selected as the control group. Blood routine examination, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level were compared between infected and non-infected group; in infection and control group blood routine examination, ESR, C-reactive protein level were compared; in non-infection and control group blood routine examination, ESR, C-reactive protein level were compared. Results The percentage of neutrophils, white blood cell count and C-reactive protein in the infected group were higher than those in the non-infected group (P<0.05). There was no significant difference in erythrocyte sedimentation rate between the two groups (P> 0.05). The percentage of neutrophils, leukocyte count, C-reactive protein and erythrocyte sedimentation rate in the infected group were higher than those in the control group (P<0.05). There was no significant difference in the percentage of neutrophils and C-reactive protein levels between the two groups (P> 0.05), and the white blood cell count and erythrocyte sedimentation rate in the non-infected group were higher than those in the control group (P<0.05). Conclusion In the diagnosis of acute pneumonia in children, it is very important to detect the blood routine, erythrocyte sedimentation rate and C-reactive protein level in children, and it is worthy of clinical use.
论著

无创血流动力学监测在儿童脓毒性休克早期液体复苏的临床应用

Clinical application of non-invasive cardiac output monitoring in the early fluid resuscitation of children with septic shock

:56-60
 
目的 探讨无创血流动力学监测(non-invasive cardiac output monitoring,NICOM)在儿童脓毒性休克早期液体复苏的临床应用评价。方法 选取2019年1月—2020年6月期间在我院PICU患儿诊断为儿童脓毒性休克61例,随机分为对照组(未接受NICOM监测29例)和干预组(接受NICOM监测32例),记录液体复苏后6、12、24小时血气分析(pH值、剩余碱、乳酸)、尿量以及病死率、NICOM监测(CO、CI、SVR、SV、SVRI、HR、MAP)等结果。结果 液体复苏6 小时后两组HR、MAP、乳酸、剩余碱、尿量比较无统计学差异 (P>0.05),液体复苏12 h后干预组乳酸较对照组降低,差异有统计学意义(P<0.05);液体复苏24 h后两组HR、MAP、乳酸、剩余碱及尿量比较,差异均有统计学意义 (P<0.05)。干预组治疗后12 h在CO、CI、SVR、SV、SVRI、HR、MAP较治疗前改善,差异均有统计学意义(P<0.05),干预组治疗后24 h在CO、CI、SVR、SV、SVRI、HR、MAP较治疗前改善,差异均有统计学意义(P<0.05)。结论 NICOM具有敏感度及准确率高,且操作简单,可有效用于指导脓毒性休克早期液体复苏,针对个体化治疗提供客观依据,正确指导容量管理,具有科学实用价值,值得推广。
Objective To evaluate the clinical application of non-invasive cardiac output monitoring (NICOM) for early fluid resuscitation in children with septic shock. Methods 61 children diagnosed with septic shock in the PICU at our hospital between January 2019 and June 2020 were randomly divided into a control group (29 without NICOM monitoring) and an intervention group (32 with NICOM monitoring), and the results of blood gas analysis (pH,lactate and residual base), urine volume, and mortality, and NICOM monitoring (CO, CI, SVR, SVRI, HR, and MAP) were recorded at 6, 12, and 24 h after fluid resuscitation. Results There was no statistically significant difference in HR, MAP, lactic acid, residual base and urine volume between the two groups after 6 h of fluid resuscitation (P>0.05), and lactic acid was lower in the intervention group than that in the control group after 12 h of fluid resuscitation (P<0.05); the differences in HR, MAP, lactic acid, residual base and urine volume between the two groups after 24 h of fluid resuscitation were all statistically significant (P<0.05). The differences were statistically significant (P<0.05) in CO, CI, SVR, SVI, HR, and MAP at 12 h and at 24 h after treatment in the intervention group compared with that of the pre-treatment (P<0.05). Conclusion NICOM has high sensitivity and accuracy and it can be operated in simple processes. It may be effectively applied to guide the early fluid resuscitation of septic shock. It also provides Objective evidence for individualized treatment and correctly guides volume management. Its scientific and practical value makes it worth promoting.
论著

唑来膦酸对预防腰椎PVP术后再发骨折的疗效评价

Effect of zoledronic acid on prevention of recurrent fracture after PVP

:52-55
 
目的 比较唑来膦酸对 PVP(椎体成形术)治疗OVCF(骨质疏松椎体压缩性骨折)术后再发骨折的影响。方法 收集2016年12月—2018年6月在我院骨科接受PVP治疗患者共70例,其中40人在术后接受了唑来膦酸治疗(观察组),30人在术后接受了安慰剂治疗(对照组),两组患者均给予维生素D和钙剂基础治疗。记录术后6个月、1年、2年腰椎骨密度;术后2年内伤椎及邻近椎体再发骨折情况。结果 观察组伤椎再发骨折率(1/40,2.5%)低于对照组(2/30,6.67%)(P<0.05);观察组邻椎再发骨折率(2/40,5%)低于对照组(7/30,23.33%)(P<0.05)。结论 唑来膦酸能较好地预防PVP术后再发骨折。
Objective To compare the effect of zoledronic acid on the treatment of osteoporotic vertebral compression fracture after percutaneous vertebroplasty PVP. Methods From December 2017 to June 2019, a total of 70 patients who received PVP in the hospital medical plastic surgery clinic, 40 patients were collected received zoledronic acid (group A) and 30 patients received placebo (group B) after operation. Both groups received basic treatment of vitamin D and calcium. The bone mineral densits (BMD) of lumbar vertebrae were recorded at 6 months, 1 year and 2 years after operation, and the recurrent fractures of injured vertebrae and adjacent vertebrae were recorded at 2 years after operation. Results The rate of recurrent fracture of vertebrae in group A (1/40, 2.5%) was lower than that in group B (2/30, 6.67%); the rate of recurrent fracture of adjacent vertebrae in group A (2/40, 5%) was grcartly lower than that in group B (7/30, 23.33%). Conclusion Zoledronic acid can prevent recurrent fracture after PVP.
论著

HPV联合TCT检测对宫颈病变诊断的预测价值

Predictive value of HPV combined with TCT in the diagnosis of cervical lesions

:48-51
 
目的 探讨宫颈病变诊断中HPV联合TCT(薄层液基细胞学)检测的预测价值。方法 本文将2019年2月—2020年2月收治的宫颈病变患者90例作为研究对象,对所有患者实施HPV检测、TCT检测及阴道镜活检,将阴道镜检查结果作为金标准,统计分析TCT检测与病理结果比较、HPV检测与病理结果比较、联合检测与病理结果比较及诊断准确率。结果 90例患者经病理检查显示宫颈正常27例、CINⅠ期27例、CINⅡ期11例、CINⅢ期14例、宫颈癌11例;TCT检测显示宫颈正常19例、ASCUS 33例、LSIL 22例、HSIL 12例、SCC 4例。经HPV检测显示阳性73例,阴性17例;联合检测显示阳性88例,阴性2例;联合检测准确率与病理结果之间差异无统计学意义,P>0.05。结论 HPV检测联合TCT检测在宫颈病变中具有较高的预测价值,准确度较高且具有无创性,可有效降低阴道镜活检的概率或者手术探查的概率,患者医疗负担相对较轻,可将其应用于宫颈病变的大规模筛查中。
Objective To investigate the predictive value of HPV combined with TCT (thinprep cytology test) in the diagnosis of cervical lesions. Methods 90 patients with cervical lesions from February 2019 to February 2020 were selected as the research objects. HPV detection, TCT detection and colposcopy biopsy were carried out for all patients. The colposcopy results were taken as the gold standard. The comparison of TCT detection and pathological results, HPV detection and pathological results, joint detection and pathological results comparison and diagnostic accuracy were statistically analyzed. Results Pathological examination showed that 27 cases of normal cervix, 27 cases of CIN Ⅰ, 11 cases of CIN Ⅱ, 14 cases of CIN Ⅲ and 11 cases of cervical cancer; TCT showed 19 cases of normal cervix, 33 cases of ASCUS, 22 cases of LSIL, 12 cases of HSIL and 4 cases of SCC. HPV test showed that 73 cases were positive and 17 cases were negative; 88 cases were positive and 2 cases were negative by combined detection; there was no significant difference between the accuracy of combined detection and pathological results, P>0.05. Conclusion HPV detection combined with TCT detection in cervical lesions has high predictive value, high accuracy and non-invasive. It can effectively reduce the probability of colposcopy biopsy or surgical exploration. It makes patients with relatively light medical burden, may be applied to large-scale screening of cervical lesions.
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