育龄期女性异常阴道出血：全科医疗中初始管理的描述性研究

Abnormal vaginal bleeding in women of reproductive age: a descriptive study of initial management in general practice.

作者信息

de Vries Corlien J H, Wieringa-de Waard Margreet, Vervoort Cléo-Lotte A G, Ankum Willem M, Bindels Patrick J E

机构信息

Division of Clinical Methods and Public Health, Department of General Practice, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.

出版信息

BMC Womens Health. 2008 Apr 15;8:7. doi: 10.1186/1472-6874-8-7.

DOI:10.1186/1472-6874-8-7

PMID:18412967

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2358883/

Abstract

BACKGROUND

Abnormal vaginal bleeding (AVB) in women of reproductive age is a common reason for consulting a general practitioner. Nevertheless, how general practitioners (GPs) choose to initially manage AVB is largely unknown, as is the prevalence of underlying pathology of AVB in primary care.

METHODS

To investigate the initial diagnostic procedures and treatment for AVB used in general practice, we performed a descriptive study based on computerised medical records. New consultations for AVB in 2000 and 2001 were selected. Patient characteristics, diagnostic procedures and treatment were analysed.

RESULTS

In total, 270 new consultations were included. The majority of patients (75%) consulted the GP for AVB only once. GPs performed diagnostic procedures in 54% of all consultations. Overall, additional diagnostic procedures revealed abnormalities in 11% of women. However, the diagnostic procedures implemented by the GPs varied widely per bleeding type and contraceptive use. Anaemia was found in 36% of 45 women tested. Uterine fibroids were found in 41% of 27 women examined by ultrasound. Medication was prescribed in 34% of all consultations. A gynaecological referral was registered in 4% of all contacts.

CONCLUSION

Initially, GPs tend to follow a policy of expectant management in women of reproductive age with AVB. However, when additional diagnostic procedures were performed, anaemia and uterine fibroids were found in a considerable number of women.

摘要

背景

育龄期女性异常阴道出血（AVB）是咨询全科医生的常见原因。然而，全科医生（GP）最初选择如何处理AVB在很大程度上尚不清楚，AVB在初级保健中的潜在病理患病率也是如此。

方法

为了调查全科医疗中用于AVB的初始诊断程序和治疗方法，我们基于计算机化医疗记录进行了一项描述性研究。选取了2000年和2001年因AVB进行的新咨询病例。分析了患者特征、诊断程序和治疗情况。

结果

总共纳入了270例新咨询病例。大多数患者（75%）因AVB仅咨询过全科医生一次。全科医生在所有咨询病例中的54%进行了诊断程序。总体而言，额外的诊断程序在11%的女性中发现了异常。然而，全科医生实施的诊断程序因出血类型和避孕使用情况而有很大差异。在45名接受检测的女性中，36%发现有贫血。在27名接受超声检查的女性中，41%发现有子宫肌瘤。在所有咨询病例中的34%开具了药物处方。在所有就诊病例中的4%记录了妇科转诊。