2018年子宫内膜异位症诊治现状方便抽样调查报告

A convenience sampling questionnaire survey of the current status of diagnosis and treatment of endometriosis in China in 2018

目的了解我国子宫内膜异位症(内异症)诊治的现状、诊治指南实际推行的情况以及基层医生对内异症继续教育的需求。方法本调查采取现况调查的研究设计,方便抽样的方法,通过微信问卷对妇科医生在微信公众号、微信群进行网络调查,参与者无偿自愿参与。在问卷网络平台收集数据并进行统计学分析。问卷包含41个问题,分为7个部分,内容涉及参与者的一般情况,其所在医院内异症专科门诊的开展情况,参与者内异症的接诊量、手术量及手术种类构成情况,参与者对诊治指南的了解情况,知识更新情况,其临床实践中诊治指南的推行情况,参与者对自身问题的总结及对学术机构的要求。问卷的所有问题都完成者判为有效问卷。结果本调查共收到1494份有效问卷,参与者来自全国15个省、直辖市和自治区。参与者中60.17%(899/1494)来自三级医院,32.60%(487/1494)来自二级甲等医院。仅9.97%(149/1494)的参与者所在医院开设了内异症专科门诊。70.35%(1051/1494)的参与者表示阅读过2015年发布的《子宫内膜异位症的诊治指南》。25.03%(374/1494)的参与者表示在临床实践中应用了美国生殖医学学会(ASRM)分期,仅18.74%(280/1494)的参与者表示在内异症不孕的手术中常规进行了内异症生育指数(EFI)评分。45.18%(675/1494)的参与者表示在最近的6个月中没有参加过内异症诊治指南相关的学术活动。64.46%(963/1494)的参与者认为自己的“诊疗实践有待规范”,87.15%(1302/1494)的参与者希望组织更多的内异症诊治指南的巡讲。结论目前我国的内异症诊治水平虽然有了长足的提高,但内异症专科门诊尚未普遍开展,诊治指南的推行仍然面临艰巨的任务。进一步推行诊治指南,组织更多的诊治指南的巡讲是目前广大基层医生对学术机构工作提出的迫切要求。

Objective To further understand the current status of diagnosis and treatment of endometriosis in China,the implementation of guideline in different levels of hospitals,and the need for continuing education in endometriosis among primary doctors.Methods The survey was conducted in the form of convenience sampling questionnaire among the Wechat public platform.The doctors were free to participate in the investigation without any reward.All questions answered were assessed as valid questionnaire.The datas were collected on the questionnaire network platform and analyzed by SPSS 19.0.Results Totally 1494 valid questionnaires were collected in this survey.60.17%(899/1494)of them were from tertiary hospital,and 32.60%(487/1494)were from grade two hospital.Only the hospitals where 9.97%(149/1494)participants based opened the specialist clinic for endometriosis.70.35%(1051/1494)of participants said they had read the second edition of guideline for the diagnosis and treatment of endometriosis which published in 2015.The American Society for Reproductive Medicine(ASRM)staging system was adopted in the clinical practices of only 25.03%(374/1494)participants.And 18.74%(280/1494)participants used the endometriosis fertility index(EFI)scoring during the laparoscopic surgery for endometriosis with infertility.45.18%(675/1494)of participants said they had not attended any academic conference on endometriosis in the past six months.64.46%(963/1494)of the participants believed their diagnosis and treatment in practice should be improved and standardized.87.15%(1302/1494)of the participants expressed the hope that more conferences or workshops on endometriosis would be held.Conclusions At presents,the diagnosis and treatment of endometriosis in China has been greatly improved,but the implementation of guidelines and the new concept is still a long-term job.The specialist clinic are held only in a few hospitals.It’s the expectation and voice of primary doctors to the association to organize the more academic congresses on endometriosis.