赞比亚一家教学医院产科瘘患者的特点和手术修复效果:回顾性横断面研究

M. Imakando, C. Michelo, Tapiwa Mkandawire, L. Kasonka
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摘要

背景产科瘘管病是全球公共卫生关注的一种慢性产妇疾病。这种情况是可以预防的,在大多数情况下是可以治疗的。手术修复是治疗的主要方法,成功率各不相同。本研究的目的是确定在赞比亚卢萨卡的一家教学医院患有产科瘘的妇女的特点、手术结果和影响手术结果的因素。方法回顾性分析2017年至2019年在妇女新生儿医院接受产科瘘修复手术的所有妇女的医疗记录。进行描述性分析。Fischer精确检验用于测量手术结果与模型中变量之间的关联。结果29例行瘘管修补术的患者中有18例被检索和分析。年龄15 ~ 47岁,平均29岁。超过三分之二(72.23%)的女性曾多次分娩,超过四分之三(77.8%)的女性曾剖腹产。术后2周瘘管修复成功率为83%。研究结果不足以显示成功修复与模型中因素之间的显著关联。结论产科瘘患者多为多胎患者,既往有长时间分娩、剖宫产史和不良分娩结局。妇女和新生儿医院产科瘘修复术后2周的成功率为83%。需要进一步的研究来评估长期结果和影响手术结果的因素。
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Characteristics and Surgical Repair Outcomes of Obstetric Fistula Patients Managed at a Teaching Hospital in Zambia: A Retrospective Cross Sectional Study
Background The obstetric fistula is a chronic maternal morbidity of global public health concern. The condition is preventable and in most cases treatable. Surgical repair is the mainstay of treatment with varying degrees of success. The aim of this study was to determine the characteristics, surgical outcomes and factors influencing surgical outcomes of women presenting with obstetric fistulas at a Teaching Hospital in Lusaka, Zambia. Methods A retrospective review of medical records for all women who underwent obstetric fistula repair surgery at Women and Newborn Hospital from 2017 to 2019.  Descriptive analysis was done. Fischer’s exact test was used to measure association between surgical outcomes and variables in the model. Results In total, 18 out of 29 records of patients who underwent fistula repair were retrieved and analyzed. Ages ranged from 15 to 47 years, mean age 29years. Over two thirds (72.23%) were multiparous, and over 3/4ths (77.8%) underwent caesarean section in the antecedent pregnancy. Success rate for fistula repair was 83% at 2 weeks post-operative. Study findings were inadequate to show a significant association between successful repair and factors in the model. Conclusion Majority of women presenting with obstetric fistula were multiparous with a history of prolonged labour, delivery by cesarean section and poor birth outcomes. The success rate for obstetric fistula repair at Women and Newborn Hospital was 83% at 2weeks postoperative. Further studies are needed to assess long-term outcomes and factors influencing surgical outcomes.
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