Australian & New Zealand Journal of Obstetrics & Gynaecology最新文献_第10页

The use of intraperitoneal chemotherapy for advanced ovarian cancer – The experience of a tertiary referral centre 使用腹腔化疗晚期卵巢癌-三级转诊中心的经验。

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-11-22 DOI: 10.1111/ajo.13767

Leon Foster, Christina Girgis, Adrienne Kirby, Paul Harnett, Alison Brand

Background

Platinum-based chemotherapy is the backbone of the medical management of ovarian cancer. The dose, route and timing of treatment are ongoing areas of debate. Intraperitoneal (IP) chemotherapy is an alternative delivery method treatment to the conventional intravenous (IV) route for patients with epithelial ovarian cancer, with efficacy supported by Level 1 evidence.

Aims

To compare the outcomes and feasibility of IP to IV delivery of platinum-based chemotherapy in patients with advanced epithelial ovarian cancer.

Materials and Methods

In a single institution, patients receiving adjuvant chemotherapy (IP and IV) for Stages III and IV epithelial ovarian cancer over the period January 2006–December 2018 were identified through a prospectively maintained database. All patients with an IP port inserted were included. A control group of patients treated with IV chemotherapy was created using criteria identified during the study and in the randomised trials that tested IP chemotherapy. Assessments were made for relapse-free survival (RFS) and overall survival (OS) for each cohort.

Results

A total of 639 patients received adjuvant chemotherapy (73 IP and 566 IV) during the study period. Both the IP group and matched IV control group (65 patients) had a median RFS of 26 months. The median OS in the IP group was 63.9 months, and in the IV group was 57.2 months. At ten years, a significantly higher proportion of patients were alive in the IP group cohort (16% vs 3%, relative risk 5.5, 95% CI 1.29–24, P = 0.012). IP chemotherapy was well tolerated by our cohort. In the IP group, 73% had four or more IP cycles and 99% received six or more cycles of chemotherapy.

Conclusions

Our cohort had a high rate of completion of IP chemotherapy with excellent rates of completion of six cycles of any treatment. The RFS and OS in the IP chemotherapy group were comparable to each other and reflected those in the published literature. A significantly higher proportion of patients in the IP cohort were alive at ten years than in the IV cohort.

背景:铂类化疗是卵巢癌医学管理的支柱。治疗的剂量、途径和时间是目前存在争议的领域。腹腔化疗(IP)是传统静脉(IV)途径治疗上皮性卵巢癌患者的替代给药方法，其疗效得到1级证据的支持。目的:比较晚期上皮性卵巢癌患者口服给药与静脉给药铂基化疗的疗效和可行性。材料和方法:在单一机构中，通过前瞻性维护的数据库确定2006年1月至2018年12月期间接受III期和IV期上皮性卵巢癌辅助化疗(IP和IV)的患者。所有植入IP端口的患者均纳入研究。根据研究期间确定的标准和测试IP化疗的随机试验中确定的标准，创建了接受静脉化疗治疗的对照组。评估每个队列的无复发生存期(RFS)和总生存期(OS)。结果:研究期间共639例患者接受了辅助化疗(IP 73例，IV 566例)。IP组和匹配的静脉注射对照组(65例)的中位RFS为26个月。IP组的中位OS为63.9个月，IV组为57.2个月。10年时，IP组患者的生存率显著高于对照组(16% vs 3%，相对危险度5.5,95% CI 1.29-24, P = 0.012)。我们的队列对IP化疗耐受良好。在IP组中，73%的患者有4个或更多的IP周期，99%的患者接受了6个或更多的化疗周期。结论:我们的队列有很高的IP化疗完成率，任何治疗的6个周期的完成率都很好。IP化疗组的RFS和OS具有可比性，反映了已发表的文献。与IV组相比，IP组患者在10年时存活的比例明显更高。

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引用次数: 0

Fostering interdisciplinary colorectal and gynaecology surgery networks during training is crucial to maximise expertise and innovate patient care 在培训期间培养跨学科的结直肠和妇科手术网络对于最大限度地发挥专业知识和创新患者护理至关重要。

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-11-20 DOI: 10.1111/ajo.13774

Mina Sarofim, Mikhail Sarofim

The importance of interdisciplinary collaboration between specialties has gained significant recognition in recent years, and rightly so with notable benefits to skills acquisition and patient outcomes. Due to the scope of overlapping procedures and clinical scenarios, developing trustable networks between colorectal and gynaecology surgeons must be encouraged as a focus of trainee education. This article highlights the benefits, challenges, and recommendations for fostering such networks.

近年来，专业之间跨学科合作的重要性得到了显著的认可，这对技能获得和患者预后有显著的好处。由于重叠手术和临床场景的范围，必须鼓励在结直肠和妇科外科医生之间建立可信赖的网络，作为培训生教育的重点。本文重点介绍了培养这种网络的好处、挑战和建议。

引用次数: 0

Incidence and management of premature rupture of membranes in Victoria, Australia: A retrospective cohort study of 636 590 births between 2009 and 2017 澳大利亚维多利亚州胎膜早破的发生率和处理:2009年至2017年636590名新生儿的回顾性队列研究。

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-11-20 DOI: 10.1111/ajo.13773

Natalie Jardine Cameron, Dagmar Wertaschnigg, Mary-Ann Davey, Renée Janne Burger, Ben Willem Mol, Andrea Mary Woolner

Background

Premature rupture of membranes (PROM) is a complication affecting 7–12% of pregnancies in which fetal chorioamniotic membranes rupture before labour begins. Preterm PROM (PPROM) (ie <37 weeks gestation) precedes one-third of preterm births, exposing the fetus to increased morbidity from placental abruption, respiratory distress syndrome and sepsis.

Aim

To analyse trends in the incidence and mode of birth in preterm and term PROM in Victoria, Australia between 2009 and 2017.

Materials and methods

This retrospective population-based cohort study included all singleton pregnancies from 2009 to 2017. We examined women with PROM (both <37 weeks (PPROM) and at term). Management was assessed in three categories: (a) expectant management; (b) induction of labour (IOL); and (c) elective caesarean section (elCS). A multinomial logistic regression model was used to adjust for confounders influencing the choice of management.

Results

Of 636 590 singleton pregnancies, 52 669 (8.3%) births with PROM at term (42 439; 6.7%) or PPROM (10 230; 1.6%) were identified. Of these, the majority were managed expectantly (n = 22 726; 43.1%), or with IOL (25 931; 49.2%). While elCS represented only 7.6% of these cases (n = 4012), its use rose consistently from 2009 to 2017 for PROM at term and PPROM alike. For women with PPROM at 34–36 weeks the odds of elCS increased by 5% annually (adjusted odds ratio (aOR) 1.05; 95% CI 1.02–1.08) and 2% for IOL (aOR 1.02; 95% CI 1.00–1.05) vs expectant management.

Conclusions

The use of elCS and IOL in PPROM is rising in Victoria, particularly between 34 and 36 completed weeks of pregnancy. Research is needed to determine the drivers for this increase.

背景:胎膜早破(PROM)是一种并发症，影响7-12%的妊娠，其中胎儿绒毛膜羊膜在分娩前破裂。目的:分析2009年至2017年澳大利亚维多利亚州早产儿和足月早PROM的发病率和出生方式的趋势。材料和方法:这项基于人群的回顾性队列研究包括2009年至2017年的所有单胎妊娠。结果:在636590例单胎妊娠中，52 669例(8.3%)足月产胎早破(42 439例;6.7%)或PPROM (10230;1.6%)。其中，大多数是预期管理的(n = 22 726;43.1%)，或合并人工晶状体(25931例;49.2%)。虽然elCS仅占这些病例的7.6% (n = 4012)，但从2009年到2017年，elCS在term PROM和PPROM中的使用率持续上升。对于34-36周PPROM的妇女，elCS的几率每年增加5%(调整优势比(aOR) 1.05;95% CI 1.02-1.08)， IOL为2% (aOR 1.02;95% CI 1.00-1.05)与预期管理。结论:在维多利亚州，elCS和IOL在PPROM中的应用正在上升，特别是在妊娠34至36周之间。需要进行研究来确定这种增长的驱动因素。

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引用次数: 0

Low-risk gestational trophoblastic neoplasia – 20 years experience of a state registry 低风险妊娠滋养细胞瘤- 20年的国家登记经验。

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-11-14 DOI: 10.1111/ajo.13772

Carmel McInerney, Orla McNally, Thomas James Cade, Antonia Jones, Deborah Neesham, Yael Naaman

Background

Gestational trophoblastic disease (GTD) is an uncommon but highly treatable condition. There is limited local evidence to guide therapy.

Aims

To report the experience of a statewide registry in the treatment of low-risk gestational trophoblastic neoplasia (GTN) over a 20-year period.

Materials and Methods

A retrospective review of the prospectively maintained GTD registry database was conducted. There were 144 patients identified with low-risk GTN, of which 115 were analysed. Patient demographics, treatment details and outcomes, including development of resistance, toxicity or relapse were reviewed.

Results

The incidence of GTD was 2.6/1000 live births. There was 100% survival. The mean time from diagnosis to commencing treatment was 1.9 days (range 0–29 days). Seventy-seven percent of patients treated with methotrexate achieved complete response. Thirteen patients (11.3%) required multi-agent chemotherapy, for the treatment of resistant or relapsed disease. There was a higher rate of treatment resistance in those with World Health Organization (WHO) risk scores 5–6 (odds ratio (OR) 6.56, 95% CI 1.73–24.27, P = 0.005) and those with pre-treatment human chorionic gonadotropin >10 000 (OR 4.00 95% CI 1.73–24.27 P = 0.007). Four patients (3.5%) were diagnosed with choriocarcinoma after commencing treatment. Nine patients (7.8%) had successful surgical treatment for GTN, both alone and in combination with chemotherapy. The relapse rate was 4.3%; all were treated successfully with a combination of chemotherapy and surgery, and 93.9% of patients completed follow up through the registry.

Conclusions

Methotrexate is a highly effective treatment for low-risk GTN, especially with WHO risk score ≤4. The optimal treatment for those with risk scores of 5–6 requires further investigation.

背景:妊娠滋养细胞病(GTD)是一种罕见但可治疗的疾病。指导治疗的当地证据有限。目的:报告全州范围内低风险妊娠滋养细胞瘤(GTN)治疗20年的经验。材料和方法:对前瞻性维护的GTD注册数据库进行回顾性审查。144例患者被确定为低风险GTN，其中115例进行了分析。回顾了患者人口统计、治疗细节和结果，包括耐药性、毒性或复发的发展。结果:GTD发生率为2.6/1000活产。100%的存活率。从诊断到开始治疗的平均时间为1.9天(范围0-29天)。77%接受甲氨蝶呤治疗的患者达到完全缓解。13例患者(11.3%)需要多药化疗，用于治疗耐药或复发疾病。世界卫生组织(WHO)风险评分为5-6分的患者(优势比(OR) 6.56, 95% CI 1.73-24.27, P = 0.005)和治疗前人绒毛膜促性腺激素bbb10 000的患者(OR 4.00, 95% CI 1.73-24.27 P = 0.007)的治疗耐药率较高。4例(3.5%)患者在开始治疗后被诊断为绒毛膜癌。9例患者(7.8%)成功手术治疗GTN，无论是单独治疗还是联合化疗。复发率4.3%;所有患者均成功接受化疗和手术联合治疗，93.9%的患者通过登记完成随访。结论:甲氨蝶呤是治疗低危GTN的有效方法，特别是WHO风险评分≤4的患者。风险评分为5-6分的患者的最佳治疗方案需要进一步研究。

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引用次数: 0

The impact of body mass index on labour management and mode of delivery: A retrospective matched cohort study 体重指数对劳动管理和分娩方式的影响:一项回顾性匹配队列研究。

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-11-14 DOI: 10.1111/ajo.13769

Kan-feng Zheng, Madeleine N. Jones, Ben W. Mol, Daniel L. Rolnik

Aim

This study aims to examine the association between body mass index (BMI) and mode of delivery, progression of labour, and intrapartum interventions.

Methods

This was a retrospective matched cohort study including Class III obese (BMI ≥40 kg/m²) and normal BMI (BMI <25 kg/m²) women planning a vaginal birth who had a live, singleton delivery from January 2015 to December 2018. Patients were matched (1:1) based on age, gestational age, parity, onset of labour and birth weight. The primary outcome was caesarean delivery (CD). Secondary outcomes were delivery outcomes, intrapartum management and interventions. Rates of each outcome were compared with matched analysis, and duration of labour with time-to-event analysis.

Results

We studied two groups of 300 pregnant women. The CD rate was significantly higher for obese women than the normal BMI cohort (19.3% vs 13.3%; risk ratio (RR) 1.43, 95% CI 1.02–1.98, P = 0.035). Cervical dilation prior to CD for failure to progress was slower in obese than normal BMI (0.04 vs 0.16 cm/h). The obese cohort had a longer duration of labour in those who underwent induction (13.70 vs 11.48 h, P = 0.024). Intrapartum intervention rates were higher for obese women, with significant differences in rates of fetal scalp electrodes (72.7% vs 22.7%, RR 3.20, 95% CI 2.58–3.99, P < 0.001), intrauterine pressure catheters (18.3% vs 0%, P < 0.001), epidural analgesia (44.0% vs 37.0%, RR 1.20, 95% CI 1.01–1.44, P = 0.040) and fetal scalp lactate sampling (8.0% vs 3.0%, RR = 2.67, 95% CI 1.33–5.33, P = 0.004).

Conclusion

Class III obesity is associated with an increased risk of CD and intrapartum interventions.

目的:本研究旨在探讨体重指数(BMI)与分娩方式、产程和产时干预措施之间的关系。方法:这是一项回顾性匹配队列研究，包括2015年1月至2018年12月计划顺产的III级肥胖(BMI≥40 kg/m2)和正常BMI (BMI 2)女性。患者根据年龄、胎龄、胎次、分娩开始和出生体重进行1:1的匹配。主要结局为剖腹产(CD)。次要结局是分娩结局、产时管理和干预措施。每个结果的发生率与匹配分析进行比较，分娩持续时间与事件时间分析进行比较。结果:我们研究了两组300名孕妇。肥胖女性的乳糜泻发生率明显高于正常BMI组(19.3% vs 13.3%;风险比(RR) 1.43, 95% CI 1.02 ~ 1.98, P = 0.035)。肥胖患者在CD前未进展的宫颈扩张比正常BMI患者慢(0.04 vs 0.16 cm/h)。肥胖组接受引产的分娩持续时间较长(13.70 h vs 11.48 h, P = 0.024)。肥胖妇女的产时干预率更高，胎儿头皮电极率有显著差异(72.7% vs 22.7%， RR 3.20, 95% CI 2.58-3.99, P)。结论:III级肥胖与CD和产时干预风险增加有关。

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引用次数: 0

Identifying women with a disability in Australian maternity services: Time for a change 识别澳大利亚产妇服务中的残疾妇女:是时候做出改变了。

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-11-14 DOI: 10.1111/ajo.13771

Charlie A. Benzie, Michelle S. Newton, Helen L. McLachlan, Della A. Forster

It is estimated that over 1 billion people worldwide have a disability. In Australia, 9% of women of childbearing age have a disability, but data on disability status for women accessing maternity services are not routinely collected and data collection processes are inconsistent. Maternal disability may affect perinatal outcomes, but to understand what factors might be amenable to interventions to improve outcomes, accurate data collection on disability status is essential. This opinion piece reflects on disability identification within maternity services in Australia, identifying areas for policy and practice change.

据估计，全世界有超过10亿人患有残疾。在澳大利亚，9%的育龄妇女患有残疾，但没有定期收集有关获得产妇服务的妇女残疾状况的数据，数据收集过程也不一致。产妇残疾可能会影响围产期结局，但要了解哪些因素可能适合采取干预措施以改善结局，准确收集残疾状况的数据至关重要。这篇评论文章反映了澳大利亚产科服务中的残疾鉴定，确定了政策和实践变革的领域。

引用次数: 0

Non-invasive tests for endometriosis are here; how reliable are they, and what should we do with the results? 子宫内膜异位症的非侵入性检查在这里；它们的可靠性有多高，我们应该如何处理结果？

IF 1.7 4区医学 Q2 Medicine

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-11-07 DOI: 10.1111/ajo.13765

Simon M. Scheck, Claire Henry, Nick Bedford, Jason Abbott, Michael Wynn-Williams, Anusch Yazdani, Simon McDowell

A reliable non-invasive biomarker for endometriosis is highly likely in the coming years. In the lead-up to this, clinicians need to be aware of commercially available tests as they become accessible, be aware of the level of evidence to support them and be prepared to counsel and manage patients who present with the results of such tests. One such test gaining popularity in Europe was developed using a machine-based learning algorithm to analyse thousands of microRNAs based on a 200-patient cohort with suspected endometriosis in France. We explore the background science for this commercially available test; outline the questions that remain to be answered; and caution against its use outside of a research setting.

子宫内膜异位症的可靠非侵入性生物标志物很可能在未来几年出现。在此之前，临床医生需要意识到商业上可获得的测试，意识到支持这些测试的证据水平，并准备好为提供此类测试结果的患者提供咨询和管理。一种在欧洲越来越受欢迎的测试是使用基于机器的学习算法开发的，该算法基于法国200名疑似子宫内膜异位症患者的队列分析了数千个微小RNA。我们探索了这种商业可用测试的背景科学；概述有待回答的问题；并注意不要在研究环境之外使用它。

引用次数: 0

Short communication: Where is women's cardiovascular health taught in Australian and New Zealand medical schools? 简短交流：澳大利亚和新西兰医学院在哪里教授女性心血管健康？

IF 1.7 4区医学 Q2 Medicine

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-11-06 DOI: 10.1111/ajo.13760

Aphakorn Hasdarngkul, Annemarie Hennessy, Shivany Vignarajan

Cardiovascular disease is a major cause of mortality in women and is the leading cause of pregnancy-related mortality in Australia. This study aims to discover the extent of teaching regarding women's cardiovascular health in Australian and New Zealand medical schools. All 22 medical schools in Australia and New Zealand were approached for participation in completing this survey. Seven medical schools (32%) completed the survey and demonstrated that within our sample population, findings suggest that while women's cardiovascular health is present in medical curricula, there is a large variability in the rigour and depth as to which it is taught, as well as possible lack of explicit teaching and examination regarding this topic.

心血管疾病是妇女死亡的主要原因，也是澳大利亚妊娠相关死亡率的主要原因。本研究旨在了解澳大利亚和新西兰医学院关于女性心血管健康的教学情况。澳大利亚和新西兰的所有22所医学院都被邀请参与完成这项调查。七所医学院（32%）完成了这项调查，并证明在我们的样本人群中，研究结果表明，尽管医学课程中存在女性心血管健康，但其教学的严格性和深度存在很大差异，而且可能缺乏关于这一主题的明确教学和考试。

引用次数: 0

Causes of stillbirth in ethnically diverse women in a Perth metropolitan hospital: A retrospective study 珀斯大都会医院不同种族女性死产原因的回顾性研究。

IF 1.7 4区医学 Q2 Medicine

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-10-31 DOI: 10.1111/ajo.13761

Kriti Sharma, Saiuj Bhat, Sangeeta Malla Bhat

Background

Most published reports analysing the differences in causation of stillbirth between different ethnic groups focus on stillbirth risk factors, with a paucity of data comparing actual causes of stillbirth.

Aims

To determine whether causes of stillbirth differ between Caucasian and non-Caucasian ethnic groups in an Australian context.

Materials and Methods

Data from all stillbirths occurring at 20 or more completed weeks of gestation between 1 January 2010 and 31 December 2020 at a secondary level, outer metropolitan hospital, were analysed in this retrospective case series. Causes of stillbirth as determined by perinatal autopsy and placental histopathology were categorised using the Perinatal Society of Australia and New Zealand Perinatal Death Classification and compared between Caucasian and non-Caucasian groups.

Results

Ninety-two stillbirths (0.7% of all births) were identified during the study period. A greater proportion of non-Caucasian women had small for gestation age placentas compared to Caucasian women (n = 22/43 (51%) vs n = 12/49 (24%); P = 0.025). A greater proportion of stillbirths were caused by hypoxic peripartum death in non-Caucasian than in Caucasian women (n = 4/43 (9%) vs n = 0/49 (0%); P = 0.044), and a greater prevalence of placental dysfunction was seen in the non-Caucasian cohort compared to Caucasian women (n = 14/43 (33%) vs n = 8/49 (16%); P = 0.057).

Conclusions

The differences observed in causes of stillbirth between Caucasian and non-Caucasian women are hypothesis generating and warrant further larger-scale, multi-centred studies using standardised definitions and classification systems to determine whether these differences persist in a more representative sample.

背景：大多数已发表的分析不同种族群体之间死胎原因差异的报告都集中在死胎风险因素上，缺乏比较死胎实际原因的数据。目的：确定在澳大利亚背景下，高加索和非高加索种族群体的死产原因是否不同。材料和方法：在本回顾性病例系列中，分析了2010年1月1日至2020年12月31日期间在外大都市二级医院妊娠20周或20周以上发生的所有死产的数据。通过围产期尸检和胎盘组织病理学确定的死产原因使用澳大利亚和新西兰围产期协会围产期死亡分类进行分类，并在高加索和非高加索人群之间进行比较。结果：在研究期间发现92例死产（占所有新生儿的0.7%）。与高加索女性相比，非高加索女性中妊娠期胎盘较小的比例更高（n = 22/43（51%）vs n = 12/49（24%）；P = 0.025）。与高加索妇女相比，非高加索妇女死产的比例更高（n = 4/43（9%）vs n = 0/49（0%）；P = 0.044），与高加索女性相比，非高加索队列中胎盘功能障碍的发生率更高（n = 14/43（33%）vs n = 8/49（16%）；P = 0.057）。结论：高加索和非高加索妇女在死产原因方面观察到的差异是假设产生的，需要进一步进行更大规模、多中心的研究，使用标准化的定义和分类系统来确定这些差异是否在更具代表性的样本中持续存在。

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引用次数: 0

Acceptability of using the Raising Awareness Tool for Endometriosis (RATE) in general practice: a mixed methods pilot study 在全科医学中使用提高子宫内膜异位症意识工具（RATE）的可接受性：一项混合方法的试点研究。

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2023-10-31 DOI: 10.1111/ajo.13768

Jacqueline Frayne, Talila Milroy, Charlotte Rook, Magdalena Simonis, Alan Lam

Aims

The Raising Awareness Tool for Endometriosis (RATE) was developed to facilitate discussions with health providers regarding endometriosis-associated symptoms. We aim to evaluate the acceptability of the RATE by general practitioners (GP), including determining the prevalence of symptoms of women presenting to general practice and immediate management of symptoms.

Methods

A mixed-methods study was undertaken using a combination of quantitative and qualitative data in Western Australian General Practices from 2021 to 2022. A purposive sample of 12 GPs were included, who recruited women (18–50 years) on attendance for consultation over a one- to two-week period, followed by qualitative interviews exploring GPs’ experiences with the tool. The quantitative and qualitative components were integrated during analysis of results.

Results

A total of 111 women completed the RATE (mean: 33, standard deviation: 8.6 years) prior to routine consultation. The tool was considered to be acceptable for use in general practice and aided discussions on symptoms and management. Overall, 68.5% of patients experienced pelvic pain or discomfort, with 22.4% rating that this interfered with quality of life. Of those with pelvic pain, 75% had associated chronic pain conditions, and 42.1% reported allodynia. The chronic pain questions provoked GP uncertainty. After symptoms were identified, GPs arranged individualised investigations and follow-up.

Conclusions

The RATE was considered to be acceptable for use in the general practice setting. It identified symptoms and initiated discussions on possible diagnosis as well as management of endometriosis. Further GP education on identifying those women at most risk of developing chronic pain syndromes is needed.

目的：开发子宫内膜异位症提高认识工具（RATE），以促进与卫生服务提供者讨论子宫内膜异位相关症状。我们的目的是评估全科医生（GP）对RATE的可接受性，包括确定接受全科医生治疗的女性症状的患病率和症状的即时管理。方法：结合2021年至2022年《西澳大利亚州一般做法》中的定量和定性数据，进行了一项混合方法研究。有目的的样本包括12名全科医生，他们招募了女性（18-50岁）年）参加为期一到两周的咨询，然后进行定性访谈，探讨全科医生使用该工具的经验。在分析结果的过程中，将定量和定性组成部分结合起来。结果：共有111名女性完成了RATE（平均值：33，标准差：8.6 年）。该工具被认为可用于全科实践，并有助于讨论症状和管理。总体而言，68.5%的患者经历了骨盆疼痛或不适，22.4%的患者认为这会影响生活质量。在骨盆疼痛患者中，75%的患者有相关的慢性疼痛，42.1%的患者报告有异常性疼痛。慢性疼痛问题引发了全科医生的不确定性。症状确定后，全科医生安排了个性化调查和随访。结论：RATE被认为是可接受的，可用于全科医疗环境。它发现了子宫内膜异位症的症状，并开始讨论可能的诊断和管理。需要进一步的全科医生教育，以确定那些最有可能患慢性疼痛综合征的女性。

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引用次数: 0