Objective To assess the safety and effectiveness of laparoscopic hysterectomy (LH) for women with benign gynecological diseases. Methods Such databases as CENTRAL (The Cochrane Library, Issue 5, 2012), MEDLINE, EMbase, CNKI, WanFang Data, VIP and CBM were searched from the date of their establishment to May 2012, meanwhile the relevant gray literature was also retrieved to identify the randomized controlled trials (RCTs) about LH versus abdominal hysterectomy (AH) for benign gynecological diseases. The literature was screened according to the inclusion and exclusion criteria by two reviewers independently, and the methodology quality was evaluated after extracting the data, then RevMan 5.1 software was used for meta-analysis. Results A total of 22 RCTs involving 3 304 patients were included. The results of meta-analysis showed that, compared with AH, LH was shorter in the time of both hospital stay (MD=–2.31, 95%CI –3.03 to –1.60, Plt;0.000 01) and postoperative recovery (MD=−13.86, 95%CI −17.70 to −10.03, Plt;0.000 01), and lower in the incidences of both postoperative fever and other nonspecific infections (OR=0.72, 95%CI 0.54 to 0.95, P=0.02), but it was higher in the incidence rate of intraoperative urinary systematic injuries (OR=2.41, 95%CI 1.21 to 4.82, P=0.012), and longer in the operation time (MD=20.27, 95%CI 3.95 to 36.59, P=0.03). There were no significant differences between the two groups in the incidence of complications such as intraoperative intestinal injuries, vessel injuries, postoperative fistulizaion, postoperative urethral dysfunction, postoperative vaginal infection, etc. (Pgt;0.05). Conclusion This systematic review shows when treating benign gynecological diseases, LH is superior to AH in shortening the time of hospital stay and postoperative recovery, and in decreasing the incidence of operative fever and other nonspecific infections, but it results in a higher incidence of intraoperative urinary systematic injuries and longer operative time. Because there is no result regarding to the postoperative long-term life quality, so it expects to be further proved by more high quality RCTs.
Objective To investigate infertile inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010, so as to provide baseline data for further research. Methods According to diagnosis criteria of WHO, we collected demographical characteristics, disease cause and cost constitution of infertility inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010. The data of each patient were input into ACCESS database and SPSS 13.0 was used for statistical analysis. Results a) From 2008 to 2010, there were 1 452 infertile patients from 33 different areas of mainland China, 79.7% of which was from the north of China. b) The mean age was 31.2±4.3 years old. The percentage of patients aged 30 to 34 years accounted for the most (40.3%). Mental laborers (23.3%) were more than physical laborers (7.2%). 36.7% of patients received education from universities and 83.1% of patients had family income ranging from 20,000 yuan to 190,000 yuan. c) The mean age of the first sexual activity was 21.4±2.9 years old. 53.7% of patients had only one sexual partner and most couples had sexual activities twice every week. The mean age of husbands was 32.9±5.5 years old with the highest percentage of 30 to 35 years old (39.2%). The percent of intellectual work of husband was the highest (35.9%). 64.9% of patients had normal semen analysis results and 23.0% never took related examination. d) 29.9% of patients was primary infertility and 70.1% was secondary infertility, of which 57.6% had either induced or medical abortion. The mean duration of infertility was 5.2±3.5 years (range 1 to 21 year). e) 76.3% of infertile patients had pelvic adhesion and 88.6% suffered from tubal disease. Among the tubal infertile patients, 23.6% had uterine disease, 5.2% had ovarian disease, 5.0% had endometriosis, 6.7% had multiple problems, and 4.8% had unexplained infertility. In patients with tubal infertility, the incidence of distal fimbria atresia (45.8%) was higher than that of proximal block (32.9%). 24.7% of patients with fimbria atresia had hydrosalpinx and among of them, 21.1% had no hydrosalpinx. 15.2% had congenital tubal defects. f) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person. The percentage of material cost was 29.1% and that of drugs was 18.2%. Conclusion a) The total number of infertile inpatients was 1 452 in gynecology department of Pingjin Hospital of Tianjin from 2008 to 2010. 79.7% of patient was from North China. Most of them were 30 to 34 years old and 44.3% had no job. The percentage of patients had university education and that of low-middle family income was the highest. Sexual activity was relatively traditional. Most husbands were 30 to 35 years old and intellectual workers, and 23.0% of them had never taken an examination of semen analysis. More patients were secondary infertile, and the duration of infertility was 1 to 21 years. b) 76.3% of patients had pelvic adhesion and 88.6% had tubal disease. The incidence of distal tubal fimbria atresia was higher than proximal tubal occlusion. c) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person which was further lower than each cycle cost of assisted reproductive technology. The overall costs included materials and drugs (47.3%), which were mainly at patients’ own expense.
目的：探讨妇科癌症患者疼痛的护理措施。方法：60例妇科癌症患者随机分为常规护理、特殊护理，观察疼痛治疗效果。结果：特殊护理患者疼痛缓解明显。结论：护理干预能改善患者疼痛。
目的：探讨女性生殖道瘘的病因及预防措施。方法：回顾性分析我院妇产科2000年1月至2005年12月收治入院的57例女性生殖道瘘病例的病因。结果：产伤和妇科手术占女性生殖道瘘病因的前两位，分别占56.1%（32/57）和33.3%（19/57）。结论：产伤和妇科手术是引起女性生殖道瘘的主要原因。加强围产期保健、积极处理产科合并症以及提高妇科手术技术是降低女性生殖道瘘发生率的关键因素。
Objective To investigate patients in gynecological endocrinology clinic with the following three pieces of information: how did they provide their symptom information, how did they understand diagnostic and therapeutic information, and what was their attitude towards the visit, and to get to know about the situation and problems in doctor-patient communication, so as to aim directly at improving the efficiency of diagnosis and treatment. Methods A total of 403 patients, who visited Prof. HAN Zi-yan’s clinic in the hospital from April to August 2010, were evaluated using self-edited Assessment on Doctor-patient Communication in Gynecological Endocrinology Outpatient Clinic. Results a) As to the situation of patients providing symptom information as well as understanding diagnostic and therapeutic information, when doctor asked, only 29% (118/403) of patients could narrate their treatment history clearly, and 38% (152/403) could tell their examination history exactly. After doctors’ explanation, only 21% (86/403) understood their examination results correctly, and 27% (108/403) understood management and therapeutic advice. The result of correlation analysis showed the accuracy of patients in providing disease information and accepting diagnostic and therapeutic information was higher in patients aged from 21 to 40 rather than those younger than 20, in patients well- educated rather than those with little education at the primary school, and in patients who were also engaged in medical work, All differences were significant (all Plt;0.05); and b) As to patients’ attitude towards visit, 55% (222/403) of patients hoped to get more attention from doctor, and 37.5% (151/403) overly expected the visit. Conclusion In the professor’s gynecological endocrinology outpatient clinic, many patients can’t clearly provide their treatment and examination history, neither understand exam situation and therapeutic advice at that visit, which are influenced by their age, education and occupation. In addition, psychological needs of patients should be concerned, too
目的 探讨妇科化学治疗（化疗）患者自我管理效能感与焦虑抑郁的关系。 方法 2011年10月－2012年1月采用中文版癌症自我管理效能感量表和医院焦虑抑郁量表对110例妇科化疗患者进行问卷调查。 结果 共收回有效问卷106份。33例（31.70%） 患者焦虑阳性，43例（41.30%） 抑郁阳性，35例（33.70%） 焦虑抑郁均为阳性；自我管理效能感得分为（86.31 ± 27.06）分，并与焦虑呈负相关（r = −0.793，P = 0.000），与抑郁呈负相关（r = −0.753，P = 0.000）。 结论 妇科化疗患者自我管理效能感与焦虑抑郁密切相关，在以后的护理工作中应该重视妇科肿瘤患者自我管理项目的构建，提高患者的自我效能，从而改善其心理状况。
目的 探讨心理干预措施对改善妇科恶性肿瘤患者的生命质量的作用及有效性。 方法 对2008年11月－2010年11月收治的87例妇科恶性肿瘤患者，随机分为试验组与对照组，试验组43例，实施心理干预及常规治疗；对照组44例，采取常规治疗；并对两组患者入院后及出院前生存质量、心理状况以问卷调查方式进行资料收集，用以比较、评价心理干预对改善妇科恶性肿瘤患者生命质量的作用及效果。 结果 妇科恶性肿瘤患者抑郁发生率为56.3%（49/87），焦虑发生率为62.1%（54/87）； 心理干预后两组患者组间各指标比较，试验组患者的总体健康状况、生存质量、角色功能、情绪功能、认知功能得分比对照组增高（P＜0.05）；试验组患者疲倦、恶心呕吐、失眠、食欲下降、便秘症状、抑郁、焦虑得分比对照组得分下降（P＜0.05）。 结论 心理干预可改变妇科肿瘤患者的负性心理倾向，缓解抑郁、焦虑等情绪，减轻化疗药物所引起的系列副作用，能有效提高其生活质量。
目的 探究妇科投诉纠纷发生的状况及原因，以改进工作方式减少投诉现象。 方法 对2005年1月－2010年12月妇科门诊和病房发生的投诉及医患纠纷资料进行收集，并对其原因进行分类统计分析，提出相关应对措施。 结果 6年间门诊及病房共发生投诉41例，纠纷8例。其医务人员技术水平不到位、服务态度差、沟通缺乏，就医环境差、收费不合理、患者自身因素等是投诉纠纷发生的主要原因。 结论 妇科是纠纷易发科室，但只要采用有效的控制措施，就能减少甚至避免医患纠纷的发生，提高患者满意度。