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产科瘘管修补术:尼日利亚基于医院的外展治疗方法的经验

Obstetric fistula repair: experience with hospital-based outreach approach in Nigeria.

作者信息

Umoiyoho Anifeiok J, Inyang-Etoh Emmanuel C, Etukumana Etiobong A

机构信息

Dept of Obstetrics & Gynecology University of Uyo Nigeria, Nigeria.

出版信息

Glob J Health Sci. 2012 Jul 5;4(5):40-5. doi: 10.5539/gjhs.v4n5p40.

Abstract

BACKGROUND

The huge back-log of obstetric fistula and the increasing incidence of the condition in Nigeria is a cause for concern for all stake-holders. This worrisome trend requires concerted effort with innovative strategies to redress the situation.

METHODS

Hospital-based outreach programs sponsored by a non-governmental organization with volunteer medical and health personnel were used to repair selected cases of obstetric fistula in Nigeria.

RESULTS

Fifty-two relatively simple obstetric fistulas were selected out of 68 (selection rate 76.5%) that presented for repair at 12 outreach programs in 5 different states of Nigeria. All the cases were repaired by one trained gynecological surgeon with a cure rate of 100%. The majority (50.0%) of the women were aged between 16 and 20 years with a mean age of 23.8 years ± 3.6. Most (80.9%) of the women in the study population were primiparous. The majority (50.0%) of the women were divorced at the time of their presentation for repair. A vast majority (76.9%) of the women had either primary level of education or no formal education. There was a preponderance (53.8%) of juxtacervical VVF among women in the study population.

CONCLUSION

The use of hospital- based outreach approach to repair simple cases of obstetric fistula if multiplied could help reduce the large number of women living with unrepaired VVF in Nigeria.

摘要

背景

尼日利亚产科瘘管病积压严重,且该病发病率不断上升,这引起了所有利益相关者的关注。这一令人担忧的趋势需要各方齐心协力,采取创新策略来扭转局面。

方法

由一个非政府组织发起,利用志愿医疗和卫生人员开展以医院为基础的外展项目,对尼日利亚选定的产科瘘管病病例进行修复。

结果

在尼日利亚5个不同州的12个外展项目中,共有68例前来修复的产科瘘管病病例,从中选出了52例相对简单的病例(选择率76.5%)。所有病例均由一名经过培训的妇科外科医生修复,治愈率达100%。大多数(50.0%)女性年龄在16至20岁之间,平均年龄为23.8岁±3.6岁。研究人群中的大多数女性(80.9%)为初产妇。大多数(50.0%)女性在前来修复时已离婚。绝大多数(76.9%)女性接受的是小学教育或未接受过正规教育。研究人群中的女性以宫颈旁矢状位阴道瘘为主(53.8%)。

结论

采用以医院为基础的外展方法修复简单的产科瘘管病病例,如果加以推广,可以帮助减少尼日利亚大量患有未修复阴道瘘的女性人数。

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