摘要
目的:了解1986～2005年20年间北京协和医院妇科手术疾病及术式的构成变迁趋势。方法:选自北京协和医院病案管理系统,检索并调用1986年1月至2005年12月在本院接受妇科手术的患者的病历首页资料,共36582例,按疾病诊断、手术名称ICD-10标准进行分类,以第一诊断和第一术式为研究指标。结果:①20年间,我院妇科手术排名前3位的疾病仍然是子宫肌瘤、子宫内膜异位症和卵巢良性肿瘤。②手术路径方面,开腹手术构成比呈下降趋势(构成比从67.48%降为32.27%),腹腔镜手术及阴式手术的构成比逐渐升高(腹腔镜手术升高至50.07%,阴式手术升高至11.17%)。③子宫肌瘤剔除术中经开腹手术剔除的构成比逐渐下降(从96.55%降至64.13%),但仍是主要的手术方式;子宫内膜异位症中腹腔镜手术占据绝对指导地位,构成比稳中有升(从61.15%升至82.39%);卵巢良性肿瘤中腹腔镜手术的比例呈升高趋势(从25.56%升至76.13%),并逐渐成为首选手术方式。结论:20年间,妇科最常见的手术疾病变化不大。子宫内膜异位症和卵巢良性肿瘤等妇科手术的微创途径逐步代替传统的开腹手术而成为主流的手术方式。
Objective：To investigate the changing trend of gynecological operative diseases and operative approachesin PUMCH from 1986 to 2005. Methods： PUMCH inpatient Discharge Database was searched and 36582 medical records were analyzed from 1986 to 2005. Results：The leading three types of gyneco- logical operative diseases were still uterus myoma, benign ovarian tumors and endometriosis. The constitu- ent ratio of laparotomy approach declined from 67.48% to 32, 27%, while the constituent ratios of laparo- scopic and transvaginal approaches gradually increased to 50.07% and 11.17%. The constituent ratio lap- arotomy myomectomy dropped from 96.55% to 64.13%, but still was the main procedure. While laparoscop- ic surgeries were dominant inendometrisis, constituent ratio increased from 61.15% to 82.39%. The same was for benign ovarian tumors with the ratio increased from 25.56% to 76.13%. Conclusions：There is no big change of gynecologic operative diseases during the past 20 years. The minimally invasive surgery has become the mainstream procedure compared with traditional laparotomy approach, especially for leiomyoma and benign ovarian tumor.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2012年第9期767-770,共4页
Journal of Practical Obstetrics and Gynecology
关键词
妇科手术疾病
妇科手术方式
变迁
Gynecological operation diseases
Operative approach
Trends
