盆腔子宫内膜异位症手术患者不同年龄阶段的特点和趋势

摘要

Objective To study the characteristics and trends of surgical management on pelvic endometriosis of different ages. Methods The average hospital expenses and average hospital stay were compared in all pelvic endometriosis cases registered in Peking Union Medical College Hospital (PUMCH) confirmed by surgery between January 2000 and December 2009 in different age groups ( ≤30 years, ＞30 ～40 years, ＞40～50 years, and ＞50 years). The distributions of different age groups were described in different eras (2000-2004 years, 2005-2009 years), in different pathologic types ( peritoneal, ovarian, deep infiltrating endometriosis and adenomyosis ), in different surgical approaches ( laparoscopy and laparotomy) and in different surgical categories (conservative, semi-radical and radical surgery). Results Totally 10579 patients with integrated records received surgeries on pelvic endometriosis with average age ( 37. 4 ± 8. 1 ) year (16 ～81years). The ＞30～40 years group had most cases (41.1％), while the ＞50 years group had the least (4. 6％ ). From 2000 to 2009, ≤30 years group increased in a significant way (20. 1％ vs. 24. 4％, P ＜0. 001 ). With increasing ages, average hospital expenses, average hospital stay and average post-postoperative stay were increasing significantly ( all P ＜ 0. 001 ). With increasing ages, the incidence of peritoneal, ovarian, deep infiltrating endometriosis,laparoscopic surgeries and conservative surgeries were decreasing significantly ( all P ＜ 0. 001 ), while the incidence of adenomyosis, laparotomic surgeries and radical/semi-radical surgeries were increasing significantly ( all P ＜ 0. 001 ). In ≤30 years group, ovarian endometriosis, laparoscopic surgeries and conservative surgeries made up of 74. 6％, 91.3％and 98. 0％ case respectively. Conclusion Age is a significant affecting factor of surgeries on pelvic endometriosis.%目的 研究盆腔子宫内膜异位症(盆腔内异症)在不同年龄患者中的分布特点及趋势.方法 通过查阅2000年1月至2009年12月间北京协和医院登记的且经手术证实为盆腔内异症的病例,比较不同年龄阶段(≤30岁,＞30～40岁,＞40～50岁,＞50岁)患者的平均住院费用、平均住院时间和平均术后住院时间,比较不同年龄阶段在不同时期(2000-2004年及2005-2009年)、不同病理类型(腹膜型、卵巢型、深部浸润型内异症和子宫腺肌病)、不同手术路径(腹腔镜手术及开腹手术)和不同手术方式(保守手术、半根治手术、根治手术)中的分布.结果 总计10597例盆腔内异症患者进入研究,年龄平均(37.4±8.1)岁(16～81岁).＞30～40岁年龄组患者所占比例最大(41.1%),＞50岁组最少(4.6%).从2000年至2009年,≤30岁年龄组增长最快(20.1%vs.24.4%,P＜0.001).在不同年龄组之间,随着年龄增加,平均住院费用、平均住院时间和平均术后住院时间均持续增加(P均＜0.001).随着年龄增加,腹膜型、卵巢型和深部浸润型内异症所占比例以及腹腔镜手术、保守手术所占比例均持续降低,而腺肌病所占比例和开腹手术、根治或半根治手术所占比例均持续增加(P均＜0.001).在≤30岁年龄组,卵巢型内异症、腹腔镜手术和保守手术分别达74.6%、91.3%和98.0%.结论 年龄是影响盆腔内异症手术治疗特点和趋势的重要因素.