Husby Gunhild Kalleberg, Haugen Ragnhild Skipnes, Moen Mette Haase
Department of Obstetrics and Gynecology, St Olav's Hospital, Trondheim University Hospital, N-7006 Trondheim, Norway.
Acta Obstet Gynecol Scand. 2003 Jul;82(7):649-53. doi: 10.1034/j.1600-0412.2003.00168.x.
Women with endometriosis claim that delayed diagnosis is a problem. Anglo-American studies have shown a delay from 3 to 11 years between the onset of pain symptoms and the final diagnosis of endometriosis. The aim of this study was to find the time difference between the onset of pelvic pain symptoms and the final diagnosis of endometriosis among Norwegian patients.
Questionnaires were sent to 400 women, of whom 313 were members of the Norwegian Endometriosis Association and 87 were patients with endometriosis being hospitalized at St Olav's Hospital, Trondheim, in recent years. The response rate was 89%. Among the 356 questionnaires returned, 95 were excluded as not fulfilling the inclusion criterion of surgically verified symptomatic endometriosis or incomplete questionnaires. Data were analyzed from 261 women, of whom 223 were members of the Norwegian Endometriosis Association. In all included patients, pain was an indication for diagnostic surgery.
The mean delay in diagnosis was 6.7 +/- 6.2 years and the median delay was 5.0 years for the two groups in total. There was no statistically significant difference in delay between the two recruitment groups. Mean delay in diagnosis had not changed significantly with time. Women reporting infertility in addition to pain did not have a significantly shorter delay.
In Norway there is a considerable delay in the diagnosis of endometriosis, with figures comparable to results from Anglo-American studies. A greater awareness of symptoms of endometriosis and a more rapid investigation should thus be encouraged.
患有子宫内膜异位症的女性称延迟诊断是个问题。英美的研究表明,从疼痛症状出现到最终确诊子宫内膜异位症之间的延迟时间为3至11年。本研究的目的是找出挪威患者盆腔疼痛症状出现与最终确诊子宫内膜异位症之间的时间差。
向400名女性发放了问卷,其中313名是挪威子宫内膜异位症协会的成员,87名是近年来在特隆赫姆市圣奥拉夫医院住院的子宫内膜异位症患者。回复率为89%。在回收的356份问卷中,95份因不符合经手术证实的症状性子宫内膜异位症的纳入标准或问卷不完整而被排除。对261名女性的数据进行了分析,其中223名是挪威子宫内膜异位症协会的成员。所有纳入的患者均因疼痛而接受诊断性手术。
两组总的诊断平均延迟时间为6.7±6.2年,中位延迟时间为5.0年。两个招募组在延迟时间上没有统计学上的显著差异。诊断的平均延迟时间并未随时间有显著变化。除疼痛外还报告有不孕问题的女性,其延迟时间并没有显著缩短。
在挪威,子宫内膜异位症的诊断存在相当大的延迟,这一数据与英美的研究结果相当。因此,应鼓励提高对子宫内膜异位症症状的认识并加快检查速度。