2002年-2016年某医院妇科手术疾病谱和手术方式的变迁  

Changes of Gynecological Operative Diseases and Operative Approaches in a Hospital from 2002 to 2016

作　　者：李伟荣[1] 王慧英[1] 

机构地区：[1]首都医科大学附属北京友谊医院,北京市100050

出　　处：《中国病案》2017年第10期77-80,共4页Chinese Medical Record

摘　　要：目的了解2002年-2016年15年间某医院妇科手术疾病及术式的构成变迁趋势。方法资料来自某医院病案管理系统,检索并调用2002年1月至2016年12月接受妇科手术的患者的病案首页资料,共17 867例,按疾病诊断、手术名称ICD-10及ICD-9-CM-3标准进行分类,以第一诊断和第一术式为研究指标。结果 15年间某院妇科手术的主要疾病是子宫肌瘤、子宫内膜异位症和卵巢良性肿瘤。手术路径方面显示开腹手术的构成比逐渐降低,由90.58%降至34.01%,腔镜手术及阴式手术的构成比逐年增高,腔镜手术升高至63.48%,阴式手术升至2.51%。妇科常见疾病手术方式中腔镜手术的构成比均逐年增高,子宫肌瘤剔除术中经开腹手术剔除的构成比逐渐下降,从98.63%降至74.59%,但仍是主要的手术方式;生殖道息肉中腔镜手术占据绝对指导地位,构成比逐年递增,从37.44%升至91.53%;卵巢良性肿瘤中腔镜手术的比例呈升高趋势,从5.88%升至50.55%,逐渐成为首选手术方式。结论 15年间,妇科最常见的手术疾病变化不大。生殖道息肉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 approaches in a hospital from 2002 to 2016. Methods Inpatient discharge database was searched and the front pages of medical records of 17867 patients were analyzed from 2002 to 2016. To conduct classification according to the diseases＇ diagnosis, operation names of ICD-10, and the first diagnosis and first operation were the research indexes. Results The leading three types of gynecological operative diseases were still uterus myoma, benign ovarian tumors and ndometriosis. The constituent ratio of laparotomy approach declined from 90.58% to 34.01% while the constituent ratios of endoscope（laparoscopic and hysteroscope） and transvaginal approaches gradually increased to 63.48% and 2.51%. The constituent ratio laparotomy myomectomy dropped from 98.63% to 74.59%, but still was the main procedure. While laparoscopic surgeries were dominant in genital tract polyps, constituent ratio increased from 37.44% to 91.53%. The same was for benign ovarian tumors with the ratio increased from 5.88% to 50.55%.Conclusions There was no big changes of gynecologic operative diseases during the past 15 years. The minimally invasive surgery has become the mainstream procedure instead of traditional laparotomy approach, especially for genital tract polyps and benign ovarian tumors.

关 键 词：妇科手术疾病 妇科手术方式 变迁 

分 类 号：R197.323[医药卫生—卫生事业管理] R713[医药卫生—公共卫生与预防医学]