接受紧急妇科手术的育龄妇女的医疗和社会特征

Yu.R. Dyakunchak, V. Pyrohova, І.І. Okhabska
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摘要

目的:探讨育龄妇女急诊妇科手术的医学和社会特点。材料和方法。该研究队列包括135名因卵巢中风接受紧急手术的育龄妇女(43;31.9%),异位妊娠(57;42.2%),合并卵巢肿瘤(35例;25.9%)。入选标准:年龄19 ~ 40岁;术中确认卵巢中风、异位妊娠、卵巢复杂形成;患者参与研究的知情同意。社会和临床数据记录在已编制的问卷中,其中包括社会和家庭数据、专业和物质因素、躯体和产科和妇科记忆。使用标准的Microsoft Excel 7.0和“Statistica 6.0”程序对结果进行统计处理。确定26名(19.3%)妇女根本没有看过妇科医生,其中18名(69.2%)没有性活动,8名(30.8%)患者没有怀孕计划,因此认为没有必要去看医生。紧急外科手术患者的妇科记忆的另一个特点是由于类似的妇科病理反复手术干预。卵巢卒中患者再次住院的占26.9%,再次手术的占19.2%。17.3%的妇女有重复异位(输卵管)妊娠,其中13.5%的患者有重复手术。卵巢肿瘤复发并紧急手术治疗的发生率为25.8%。在紧急外科手术后,缺乏对患者进行病理合理的医疗和预防措施的全面覆盖,导致类似妇科病理的复发和反复的紧急手术干预。所获得的结果表明,需要对影响急性妇科疾病发生频率的因素进行多方面分析,并在将现代组织技术引入实践的同时,对医疗和诊断方法进行科学论证。
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Medical and social characteristics of women of reproductive age who have undergone urgent gynecological surgery
The objective: to study the medical and social characteristics of women in reproductive age who had urgent gynecological surgical operaions.Material and methods. The studied cohort consisted of 135 women in reproductive age who had urgent surgery for ovarian apoplexy (43; 31.9 %), ectopic pregnancy (57; 42.2 %), complicated ovarian tumor (35; 25.9 %). The inclusion criteria were age from 19 to 40 years; intraoperatively confirmed ovarian apoplexy, ectopic pregnancy, complicated ovarian formation; informed consent of the patient to participate in the study. Social and clinical data were registered in the developed questionnaire, which included social and household data, professional and material factors, somatic and obstetric and gynecological anamnesis. Statistical processing of the results was carried out using standard Microsoft Excel 7.0 and “Statistica 6.0” programsResults. It was determined that 26 (19.3 %) women did not visit a gynecologist at all, 18 (69.2 %) of them did not have a sexual activity, 8 (30.8 %) patients did not plan to become pregnant, so they were not considered that it is necessary to visit a doctor. Another feature of the gynecological anamnesis of patients who had urgent surgical operations was a repeated surgical intervention due to a similar gynecological pathology. Thus, 26.9 % of patients were re-hospitalized due to ovarian apoplexy, and 19.2 % had operation again. 17.3 % of women had a repeat ectopic (tubal) pregnancy, for which 13.5 % of patients had repeated surgery. Recurrence of ovarian tumor and urgent surgical intervention occurred in 25.8 % of patients.Conclusions. The lack of full coverage of patients with pathogenetically justified medical and preventive measures after urgent surgical operations leads to the recurrence of similar gynecological pathology and repeated urgent surgical interventions. The obtained results indicate the need for a multifaceted analysis of factors affecting the frequency of acute gynecological diseases and in the scientific justification of medical and diagnostic approaches with the introduction of modern organizational technologies into practice.
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