影响全子宫切除术施术途径选择的因素的初步分析

Factors Associated with the Choice of Surgical Approach of Hysterectomy

通过回顾分析(n=1238)和电话问卷调查(n=864),分析子宫切除术手术途径(开腹、腹腔镜、阴式)选择有关的因素,并探讨其在决策过程中的作用。结果发现,疾病本身的特点是影响手术途径选择的最主要因素。如果有备选途径,医师的偏好成为重要的抉择因素。患者在决策过程中的作用除受医师影响外,还受医疗费用支付方式制约。伤口美观和术后恢复快是腹腔镜子宫切除术患者选择该途径的主要原因。

To explore the factors associated with the choice of surgical approach of hysterectomy and their roles in the decisionmaking, 1238 patients with uterine leiomyomas received hysterectomy by four selected senior surgeons in Peking Union Medical College hospital between 2002 and 2006 was analyzed. Of these patients, 874 telephone surveys were performed. The results showed that disorder itself is the most important factor affecting the procedurechoice. Given alternative surgical approaches avail- able, surgeon＇s experience becomes an important factor in determining the surgical approach. Besides influenced by surgeon＇s preference, patient＇s role in decision-making was affected by her health insurance status. For patients undertaking laparoscopic hysterectomy, quicker recovery and aesthetics aspects are the temptations for selecting this procedure.