Division of Infectious Disease, Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
J Microbiol Immunol Infect. 2012 Feb;45(1):58-64. doi: 10.1016/j.jmii.2011.09.021. Epub 2011 Dec 9.
BACKGROUND/PURPOSE: Controversy exists regarding the need for surgical intervention in patients with tubo-ovarian abscess (TOA). This study was aimed at investigating the clinical characteristics and treatment outcomes in patients with TOA at a tertiary care hospital in Taiwan.
The medical records of 83 patients who presented at the hospital with TOA between January 1, 2006, and December 31, 2007, were retrospectively reviewed. Outcomes of patients who received medical treatment alone or underwent surgical intervention were analyzed using univariate and logistic regression analyses.
Among the 83 patients with TOA, 13 patients (15.7%) underwent surgical intervention, and 70 patients (84.3%) received medical treatment alone. Significant variables related to surgical treatment in the univariate analysis were length of stay (short vs. long; t = -2.267, p = 0.026), department of admission (emergency room vs. outpatient department; χ(2) = 7.459, p = 0.006), number of live births (nulliparous vs. multiparous; χ(2) = 18.202, p = 0.001), and C-reactive protein (CRP) level (high vs. low; t = -2.250, p = 0.028). Logistic regression analysis performed to determine influential factors for surgical treatment showed that the operation odds ratio of three to four live births versus no live births was 33.995 (p = 0.043) and that of two live births versus no live births was 13.598 (p = 0.026).
Patients with TOA who underwent surgery had a longer duration of hospitalization. Among the patients who underwent surgical intervention, those admitted to the emergency room had higher CRP levels and were more likely to be multiparous.
背景/目的:对于患有输卵管卵巢脓肿(TOA)的患者,是否需要手术干预存在争议。本研究旨在调查台湾一家三级保健医院 TOA 患者的临床特征和治疗结果。
回顾性分析了 2006 年 1 月 1 日至 2007 年 12 月 31 日期间在该院就诊的 83 例 TOA 患者的病历。使用单变量和逻辑回归分析比较仅接受药物治疗和接受手术干预的患者的治疗结果。
在 83 例 TOA 患者中,13 例(15.7%)接受了手术治疗,70 例(84.3%)仅接受了药物治疗。单变量分析中与手术治疗相关的显著变量包括住院时间(长短;t=-2.267,p=0.026)、入院科室(急诊室与门诊;χ(2)=7.459,p=0.006)、活产次数(初产妇与多产妇;χ(2)=18.202,p=0.001)和 C 反应蛋白(CRP)水平(高低;t=-2.250,p=0.028)。为确定手术治疗的影响因素而进行的逻辑回归分析显示,三至四个活产与无活产的手术比值比为 33.995(p=0.043),两个活产与无活产的手术比值比为 13.598(p=0.026)。
接受手术治疗的 TOA 患者的住院时间更长。在接受手术干预的患者中,那些被收入急诊室的患者 CRP 水平更高,且更有可能是多产妇。