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[子宫切除术后的康复建议。丹麦医生意见的一项研究]

[Convalescence recommendations after hysterectomy. A study of opinions among Danish physicians].

作者信息

Møller C, Ottesen M, Kehlet H, Ottesen B S

机构信息

H:S Hvidovre Hospital, gynaekologisk-obstetrisk afdeling, laparoskopisk enhed, klinisk forskningsenhed og kirurgisk gastroenterologisk afdeling.

出版信息

Ugeskr Laeger. 2001 Dec 10;163(50):7043-7.

Abstract

INTRODUCTION

The aim of this study was to describe advice and restrictions given by Danish general practitioners (GPs) and gynaecologists to patients after uncomplicated hysterectomy.

MATERIALS AND METHODS

Four hundred and ninety-one randomly selected GPs and 433 gynaecologists received a postal questionnaire in 1998/1999. The questions concerned the length of recommended sick leave, lifting restrictions, and time to resumption of seven defined common activities after hysterectomy. In addition, the gynaecologists were asked about the use of vaginal packaging, bladder catheters, and expected length of hospital stay.

RESULTS

The total response rate was 72%. GPs and gynaecologists recommended a median of 4 weeks (1-8 weeks) of convalescence after hysterectomy to patients, whose work did not involve heavy lifting, and a median of six weeks (2-12 weeks) to women, whose work did. Responses concerning the resumption of common activities showed considerable variation, for instance patients were advised to postpone sexual intercourse for a median of four weeks postoperatively (0-12 weeks). Lifting restrictions varied from lifting a maximum of 15 kg for two weeks to a maximum of 2 kg for 12 weeks.

CONCLUSION

A considerable variation was found in recommendations and regimens for hysterectomised patients. Evidence-based guidelines do not exist, and until these are available, the national and local boards of physicians need to agree on what restrictions should be given to patients.

摘要

引言

本研究旨在描述丹麦全科医生(GP)和妇科医生在患者进行非复杂性子宫切除术后给予的建议和限制。

材料与方法

1998/1999年,491名随机选取的全科医生和433名妇科医生收到了一份邮政调查问卷。问题涉及推荐的病假时长、提举限制以及子宫切除术后恢复七项特定常见活动的时间。此外,还询问了妇科医生关于阴道包扎、膀胱导管的使用以及预期住院时长的情况。

结果

总回复率为72%。对于工作不涉及重体力劳动的患者,全科医生和妇科医生建议子宫切除术后的康复时间中位数为4周(1 - 8周);对于工作涉及重体力劳动的女性,建议的康复时间中位数为6周(2 - 12周)。关于恢复常见活动的回复显示出相当大的差异,例如,建议患者术后推迟性生活的时间中位数为4周(0 - 12周)。提举限制从两周内最多提举15千克到12周内最多提举2千克不等。

结论

子宫切除术后患者的建议和康复方案存在相当大的差异。目前尚无循证指南,在这些指南出台之前,国家和地方医师委员会需要就应给予患者何种限制达成一致。

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