本文選題：北疆地區(qū) + 膽囊息肉�。� 參考：《石河子大學(xué)》2015年碩士論文

【摘要】：目的:通過(guò)分析研究北疆地區(qū)14所醫(yī)院自2011年1月到2013年12月收治的膽囊息肉患者的相關(guān)病例資料,了解北疆地區(qū)膽囊息肉的治療現(xiàn)狀及相關(guān)影響因素,為探尋可能存在的“不合理醫(yī)療干預(yù)”成因奠定基礎(chǔ)。方法:采用統(tǒng)一制定的《膽囊息肉干預(yù)情況調(diào)查表》,完整全面的收集北疆地區(qū)各州縣市14所醫(yī)院自2011年1月到2013年12月收治的膽囊息肉患者病例資料。對(duì)北疆地區(qū)膽囊息肉人口學(xué)分布、生物學(xué)分布及干預(yù)情況進(jìn)行回顧性分析研究。利用統(tǒng)一制定的《膽囊息肉認(rèn)知水平調(diào)查問(wèn)卷》對(duì)收治膽囊息肉科室醫(yī)生進(jìn)行問(wèn)卷調(diào)查,了解北疆地區(qū)相關(guān)科室醫(yī)生對(duì)膽囊息肉的認(rèn)知水平。結(jié)果:1、14家醫(yī)院共收集臨床病例資料1483份,二級(jí)醫(yī)院806例(54.35%),三級(jí)醫(yī)院677例(45.65%);手術(shù)病例1177例(79.37%),非手術(shù)病例306例(20.63%);男性患者853例(57.52%),女性患者630例(42.48%);漢族1146例(77.3%),少數(shù)民族337例(22.7%),其中回族86例,維吾爾族105例,哈族97例,蒙古族43例,錫伯族6例。年齡14-83歲,平均年齡43.17歲;2、通過(guò)B超檢出1316例(88.74%),通過(guò)CT檢出167例(11.26%);常規(guī)體檢發(fā)現(xiàn)986例(66.49%),因出現(xiàn)膽囊疾病相關(guān)臨床癥狀就診發(fā)現(xiàn)278例(18.75%),因其他疾病就診發(fā)現(xiàn)219例(14.76%);膽囊息肉大小1cm者665例,1-1.5cm者631例,1.5cm者187例。3、開(kāi)腹膽囊切除術(shù)93例、腹腔鏡下膽囊切除術(shù)833例、微創(chuàng)保膽取息肉術(shù)251例;藥物治療87例;隨訪觀察219例;4、膽固醇性息肉973例(82.67%),炎性息肉117例(9.94%),膽囊腺肌增生癥50例(4.25%),腺瘤性息肉37例(3.14%);5、≥60歲組、離退休組、沒(méi)上過(guò)學(xué)組和小學(xué)組患者較同組其他膽囊息肉患者手術(shù)率低,差異具有統(tǒng)計(jì)學(xué)意義;無(wú)保險(xiǎn)組和新農(nóng)合組較職工醫(yī)保組和居民醫(yī)保組膽囊息肉患者手術(shù)率低,差異具有統(tǒng)計(jì)學(xué)意義;少數(shù)民族較漢族膽囊息肉患者手術(shù)率高,差異具有統(tǒng)計(jì)學(xué)意義;不同性別手術(shù)率比較差異無(wú)統(tǒng)計(jì)學(xué)意義;6、膽囊息肉大小1cm組手術(shù)率較其他兩組手術(shù)率低,差異具有統(tǒng)計(jì)學(xué)意義;膽囊息肉大小1-1.5cm組與1.5cm組手術(shù)率比較差異不具有統(tǒng)計(jì)學(xué)意義;不同干預(yù)方式中有無(wú)臨床癥狀的比例不同,差異具有統(tǒng)計(jì)學(xué)意義;7、二級(jí)醫(yī)院中不符合手術(shù)指征行手術(shù)治療及符合手術(shù)指征未行手術(shù)治療的病例數(shù)較三級(jí)醫(yī)院多,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);8、三級(jí)醫(yī)院醫(yī)護(hù)人員對(duì)膽囊息肉相關(guān)知識(shí)認(rèn)知程度較二級(jí)醫(yī)院醫(yī)護(hù)人員認(rèn)知程度高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1、在北疆地區(qū)膽囊息肉的治療中大部分遵循手術(shù)指征行手術(shù)治療,但仍存在一定的過(guò)度干預(yù)問(wèn)題或干預(yù)不足問(wèn)題,二級(jí)醫(yī)院較三級(jí)醫(yī)院情況嚴(yán)重。2、目前腹腔鏡下膽囊切除術(shù)是膽囊息肉手術(shù)的主要術(shù)式,膽固醇性息肉是常見(jiàn)的病理類型。3、年齡、民族、職業(yè)、受教育程度、有無(wú)醫(yī)療保險(xiǎn)對(duì)膽囊息肉患者是否選擇行手術(shù)治療有一定影響,性別對(duì)其無(wú)影響。4、三級(jí)醫(yī)院醫(yī)護(hù)人員對(duì)膽囊息肉認(rèn)知水平較二級(jí)醫(yī)院醫(yī)護(hù)人員高。
[Abstract]:Objective: to study the clinical data of patients with gallbladder polyps treated in 14 hospitals in Northern Xinjiang from January 2011 to December 2013, and to understand the current situation of treatment of gallbladder polyps in Northern Xinjiang and the related influencing factors. In order to explore the possible causes of "unreasonable medical intervention" lay the foundation. Methods: the data of cases of gallbladder polyps from January 2011 to December 2013 in 14 hospitals in Northern Xinjiang were collected by using the questionnaire on the intervention of gallbladder polyps. The demographic distribution, biological distribution and intervention of gallbladder polyps in northern Xinjiang were analyzed retrospectively. In order to understand the cognition level of polyps of gallbladder in Northern Xinjiang, the questionnaire of cognition level of gallbladder polyps was made by using the questionnaire of cognition level of gallbladder polyps, which was conducted by doctors in department of gallbladder polyps. Results 1483 clinical cases were collected in 14 hospitals. There were 806 cases in the second class hospital, 677 cases in the third class hospital, 79.37 cases in the operation cases, 306 cases in the non-operative cases, 57.52 cases in the male patients, 630 cases in the female patients, 1146 cases in the Han nationality, 77.33 cases in the Han nationality, 337 cases in the ethnic minorities, 86 cases in the Hui nationality, 105 cases in the Uygur nationality, and 97 cases in the Kazakh nationality. There were 43 Mongolian and 6 Xibo. Aged 14-83, The mean age was 43.17 years old, 1316 cases were detected by B-mode ultrasound, 167 cases were diagnosed by CT, 66.49 cases were diagnosed by routine physical examination, 278 cases were diagnosed with clinical symptoms related to gallbladder diseases, 219 cases with other diseases, 219 cases with large gallbladder polyps. There were 665 cases with small 1cm (1-1.5 cm), 631 cases with 1.5 cm (187 cases. 3), 93 cases with open cholecystectomy, 93 cases with cholecystectomy. Laparoscopic cholecystectomy was performed in 833 cases, minimally invasive cholecystectomy in 251 cases, drug therapy in 87 cases, followed up observation in 219 cases (4 cases), 973 cases of cholesterol polyps (92.67), 117 cases of inflammatory polyps (P < 9.94), 50 cases of gallbladder adenomatosis (n = 50), 37 cases of adenomatous polyps (n = 37) and 3.145 cases (鈮，

本文編號(hào)：1833415