育龄期妇女子宫肌瘤患病影响因素及手术治疗方式的卫生经济学调查分析  

Influencing Factors of Uterine Fibroids in Women of Childbearing Age and Investigation and Analysis of Health Economics of Surgical Treatment Method

作　　者：曾令雪 王秋霞 廖莉苹 ZENG Lingxue;WANG Qiuxia;LIAO Liping(Department of Gynecology,Janyang People's Hospital,Jianyang,Sichuan,641400,China)

机构地区：[1]简阳市人民医院妇科,四川简阳641400

出　　处：《中国社会医学杂志》2023年第6期696-700,共5页Chinese Journal of Social Medicine

基　　金：成都市卫生健康委科研课题项目(202311013477)。

摘　　要：目的探究育龄期妇女子宫肌瘤患病影响因素,并从卫生经济学角度对不同手术治疗方式进行调查分析。方法选择某三级甲等医院2018年11月-2023年5月期间收治的育龄期子宫肌瘤患者1008例为子宫肌瘤组,另外选取同期于该医院进行健康体检的育龄期妇女1300例为对照组,对两组研究对象进行问卷调查,采用单因素和多因素Logistic回归分析方法对育龄期妇女子宫肌瘤患病影响因素进行分析,同时分析子宫肌瘤患者的手术治疗情况,并比较接受腹腔镜不同术式治疗的子宫肌瘤患者卫生经济学指标。结果多因素Logistic回归分析显示,年龄为40~49岁(OR=8.73,95%CI:1.67~45.75)、BMI≥24 kg/m 2(OR=4.40,95%CI:1.30~14.90)、初潮年龄<16岁(OR=7.14,95%CI:1.70~29.93)、月经紊乱(OR=3.38,95%CI:2.69~4.26)、孕次<3次(OR=2.35,95%CI:1.83~3.03)、流产史(OR=3.31,95%CI:1.21~9.07)、生殖道炎症(OR=6.07,95%CI:1.05~35.13)、家族遗传史(OR=5.92,95%CI:1.74~20.13)、口服避孕药史(OR=2.96,95%CI:1.75~5.02)是影响育龄期妇女患子宫肌瘤的危险因素(P<0.05);全子宫切除术组和子宫次全切除术组住院时间及术后住院时间长于子宫肌瘤切除术组(P<0.05),总费用、西药费、检查费、手术费及其他费高于子宫肌瘤切除术组(P<0.05)。结论年龄、BMI、初潮年龄、月经紊乱、孕次、流产史、生殖道炎症、家族遗传史、口服避孕药史是影响育龄期妇女子宫肌瘤发生的危险因素,相比于全子宫切除术和子宫次全切除术,子宫肌瘤切除术的住院时间和医疗费用更低。Objective To explore the influencing factors of uterine fibroids in women of childbearing age,and investigate and analyze the different surgical treatment methods from the perspective of health economics.Methods 1008 patients of childbearing age with uterine fibroids admitted to the hospital from November 2018 to May 2023 were selected as uterine fibroid group,and 1300 women of childbearing age who underwent physical examination in the hospital during the same period were included in control group.Questionnaire survey was conducted among the subjects of the two groups.Univariate and multivariate Logistic regression analyses were used to analyze the influencing factors of uterine fibroids in women of childbearing age,the surgical treatment of patients with uterine fibroids was analyzed,and the health economics indicators of patients with uterine fibroids treated by different laparoscopic surgery methods were compared.Results Multivariate Logistic regression analysis revealed that age of 40-49 years old(OR=8.73,95%CI:1.67-45.75),BMI≥24 kg/m 2(OR=8.73,95%CI:1.67-45.75),menarche age<16 years old(OR=7.14,95%CI:1.70-29.93),menstrual disorder(OR=3.38,95%CI:2.69-4.26),gravidity<3 times(OR=2.35,95%CI:1.83-3.03),abortion history(OR=2.35,95%CI:1.83-3.03),reproductive tract inflammation(OR=6.07,95%CI:1.05-35.13),family genetic history(OR=5.92,95%CI:1.74-20.13)and oral contraceptive history(OR=2.96,95%CI:1.75-5.02)were the risk factors for uterine fibroids in women of childbearing age(P<0.05).The postoperative hospital stay in total hysterectomy group and subtotal hysterectomy group was longer than that in hysteromyectomy group(P<0.05).The total cost,western medicine cost,examination cost,surgical cost and other costs were higher than those in hysteromyectomy group(P<0.05).Conclusion Age,BMI,age of menarche,menstrual disorder,gravidity,history of abortion,reproductive tract inflammation,family genetic history and oral contraceptive history are risk factors for uterine fibroids in women of childbearing age.Compared with tota

关 键 词：育龄妇女 子宫肌瘤 手术方式 卫生经济学 影响因素 

分 类 号：R711.74[医药卫生—妇产科学]