全子宫切除术式选择的多因素回归分析

目的回顾性分析决定全子宫切除术术式选择的临床因素,评估手术医师在其中所起的作用。方法 对285例全子宫切除术患者按照不同术式分为3组,各组间进行多因素Logistic回归分析。结果 内窥镜妇科医师明显倾向实施LH,OR值分别为13.9和11.5。伴有附件切除和子宫大(>280 g)的病例接受腹式全子宫切除术的机会显著增加.OR值分别为0.1和0.2。子宫阴道脱垂的病例更倾向接受阴式全子宫切除术,OR值为23.1。结论手术医师的经验、伴随附件切除、子宫大小和一些临床指征对全子宫切除术有独立和重要的影响。

Factors influencing the choice of hysterectomy types

Objective To identify factors influencing the choice of hysterectomy type and to evaluate the role of surgeons in the decision making process. Methods 285 patients were divided into three groups according to the hysterectomy type (AH, VH and LH) . Multivariate logistic regression analysis was used to identify independent factors influencing the choice of hysterectomy type. Results Endoscopic gynaecologists preferred LH than either AH or VH, with an odd ratio of 13.9 and 11.5 respectively. Patients with increased uterine size ( weight > 280 g) had more chance of undergoing AH than either VH or LH, with an odd ratio of 0.05 and 0.1 respectively. In addition, concomitant adnexal surgery increased the likelihood of undergoing AH than either VH or LH, with an odd ratio of 0.1 and 0.2 respectively. Patients with vaginal prolapse were more likely to undergo VH compared to AH, with an odd ratio of 23.1. Conclusion Surgeons' expertise play an important role in selection of hysterectomy type and patient' s characteristics also contribute to decision making.