Spoelhof G D
Skyline Family Medical Center, Duluth, MN 55811.
Fam Pract Res J. 1994 Mar;14(1):97-103.
To describe results achieved by family physicians performing colposcopy in our private practice.
A chart review was performed one year after initiating colposcopy services.
Forty-five patients underwent 47 colposcopic exams, most often for mild dysplasia or persistent atypia on Papanicolaou smears. Of the 21 patients with persisting atypia on smear, 16 (76.2%) showed dysplasia on biopsy. Twenty-five patients (55.6%) underwent cryotherapy, which successfully eradicated the abnormality in 16 of the 20 (80%) for whom follow-up is complete. Ten patients (22.2%) were referred to gynecologists for further evaluation and/or treatment. Six patients (13.3%) had not received the recommended follow-up after either colposcopy or cryotherapy.
Family physicians in private practice performing colposcopy and cryotherapy can provide complete care for 75% of patients with abnormal Papanicolaou smears. Patients with squamous atypia on smear may have dysplasia on biopsy more often than previously reported. A recall system and regular chart audits are recommended to improve follow-up.
描述在我们私人诊所中，家庭医生进行阴道镜检查所取得的结果。
在开展阴道镜检查服务一年后进行病历审查。
45例患者接受了47次阴道镜检查，最常见的原因是巴氏涂片显示轻度发育异常或持续性异型细胞。在涂片显示持续性异型细胞的21例患者中，16例（76.2%）活检显示发育异常。25例患者（55.6%）接受了冷冻治疗，在完成随访的20例患者中，有16例（80%）冷冻治疗成功消除了异常。10例患者（22.2%）被转诊至妇科医生处进行进一步评估和/或治疗。6例患者（13.3%）在阴道镜检查或冷冻治疗后未接受推荐的随访。
在私人诊所中进行阴道镜检查和冷冻治疗的家庭医生可为75%巴氏涂片异常的患者提供全面护理。涂片显示鳞状异型细胞的患者活检时出现发育异常的情况可能比之前报道的更为常见。建议建立召回系统并定期进行病历审核以改善随访情况。
