Odejinmi F O, Rizzuto M I, Macrae R E, Thakur V
Department of Obstetrics and Gynaecology, Whipps Cross University Hospital, London, UK.
J Obstet Gynaecol. 2008 Aug;28(6):614-7. doi: 10.1080/01443610802355544.
We set out to evaluate the effect of a programme introduced in January 2003 to make operative laparoscopy the standard surgical treatment for women requiring surgery for ectopic pregnancy. This was a retrospective and prospective clinical data analysis performed at The Whipps Cross University Hospital in London, with a comparison of data taken before and after the introduction of the programme. A total of 116 women who had surgical management for ectopic pregnancy from January 2000 to December 2002 and 313 women who had surgery for ectopic pregnancy between January 2003 and December 2006 took part in the study. A programme was started in January 2003 to make operative laparoscopy the surgical management of choice. The main outcome measure was the proportion of women requiring surgery who had operative laparoscopy in the two study periods. The chi(2)-test was used to determine if there was any statistically significant difference between proportions. A difference was deemed statistically significant if p < 0.05. The results showed that there was a progressive rise in the proportion of ectopic pregnancies managed by operative laparoscopy following the change in January 2003. A total of 34% of women were managed laparoscopically between 2000 and 2002, increasing to 90% between 2003 and 2006. This difference was statistically significant (p < 0.001). In 2006, some 96% of women requiring surgery were managed by laparoscopic surgery. The findings of this study indicate that it is possible to implement changes which increase and sustain a high rate of laparoscopic surgery for women with ectopic pregnancy requiring surgery in a district general hospital setting.
我们着手评估一项于2003年1月推出的计划的效果，该计划旨在使手术腹腔镜检查成为需要进行异位妊娠手术的女性的标准外科治疗方法。这是在伦敦惠普斯十字大学医院进行的一项回顾性和前瞻性临床数据分析，比较了该计划推出前后的数据。共有116名在2000年1月至2002年12月期间接受异位妊娠手术治疗的女性和313名在2003年1月至2006年12月期间接受异位妊娠手术的女性参与了该研究。2003年1月启动了一项计划，使手术腹腔镜检查成为首选的手术治疗方法。主要结局指标是在两个研究期间接受手术腹腔镜检查的需要手术的女性比例。使用卡方检验来确定比例之间是否存在任何统计学上的显著差异。如果p<0.05，则差异被认为具有统计学意义。结果显示，在2003年1月的变化之后，通过手术腹腔镜检查治疗的异位妊娠比例逐渐上升。2000年至2002年期间，共有34%的女性接受了腹腔镜检查，2003年至2006年期间这一比例增至90%。这种差异具有统计学意义（p<0.001）。2006年，约96%需要手术的女性接受了腹腔镜手术。这项研究的结果表明，在地区综合医院环境中，有可能实施变革，从而提高并维持对需要手术的异位妊娠女性进行腹腔镜手术的高比例。
