妇产科16岁以下住院患者228例分析

Analysis on 228 inpatients under the age of 16 in Obstetrics and Gynecology Department

目的 分析妇产科16岁以下住院青少年患者的疾病特点及治疗措施。方法 回顾性分析1993年至2004年北京大学第一医院妇产科16岁以下青少年住院病人的临床资料。结果 228例患者共住院236次；生殖道肿瘤占30．7％（70／228），其中卵巢畸胎瘤占32．9％（23／70）；生殖道外伤占19．7％（45／228），其平均年龄为10．2岁；女性生殖道发育异常占18．0％（41／228），其中单纯处女膜闭锁和先天性无阴道占51．2％（21／41）；功能失调性子宫出血占9．2％（70／228）；生殖道异物占3．5％（8／228）；生殖道炎症占2．2％（5／228）；妊娠或妊娠相关疾病占16．7％（38／228），妊娠患者中期引产比例最高。40．0％（25／62）生殖道肿瘤患者有急腹痛，24．4％（10／41）生殖道畸形患者有慢性腹痛症状。26．8％（61／228）患者伴有月经改变，20．2％（46／228）的患者伴有阴道出血的症状。86．4％（197／228）的患者以手术为主要治疗方法。结论 青少年妇产科疾病随年龄变化而疾病种类不同，月经异常是青少年妇产科疾病的常见症状，生殖道肿瘤、生殖道外伤和女性生殖道发育异常为第1～3位高发疾病，生殖道肿瘤中以卵巢畸胎瘤最为常见。手术治疗主要以去除病灶，保留生育功能，重建生殖系统的功能为主。同时应该重视生育健康知识的教育，更好的加强青少年的自我保健。

Objective To analyze the main causes and management of admissions in obstetrics and gynecology （Ob/Gyn） department for female children and teenagers under the age of 16. Methods Clinical data of 228 female patients under the age of 16 in our hospital during 1993 and 2004 was reviewed. Results These 228 patients were admitted to hospitals for 236 times. Genital neoplasm （70 cases ） was the leading cause of admission, accounting for 30. 7 % of all admissions, among which ovarian teratomas were the most common diseases. The second cause was trauma of genital tract （45 cases, 19.7 %） with an average age of 9.7. The other causes included pregnancy or pregnancy related diseases （38 cases, 16.7 %）, malformation of female genital system （41 cases, 18.0 %）, among which 51 % were imperforate hymen and congenital absence of vagina）, dysfunctional uterine bleeding （21 cases, 9.2 0%）, stuffs of genital tract （8 cases, 3, 5 %） and genital tract inflammation disease （5 cases, 2.2 %）. 40 % of genital tumor patients had acute abdominal pain and 24.4 % of patients with reproductive system malformations had chronic abdominal pain. The difference between them was significant （P〈0. 05）. Conclusion Ob/Gyn problems in teenagers possess characteristics for their age. Basic genital health education is important to children and teenagers for an early detection of possible illnesses. Appropriate medication should be provided in time after any diseases was identified, so as to minimize the damage to these patients.