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目的:研究深部浸润型子宫内膜异位症手术治疗的住院费用、住院时间、术后住院时间及其影响因素。方法:通过查阅2000年1月至2009年12月在北京协和医院登记且经手术证实为深部浸润型子宫内膜异位症的病例,比较不同年龄(≤30岁,31～40岁,>40岁)、不同时期(2000～2004年,2005～2009年)、不同病理分型(单纯型,穹窿型和直肠型)、不同手术路径(开腹手术和腹腔镜手术)、不同手术方式(保守和根治/半根治手术)、合并其他类型内异症等不同因素类别的平均住院费用、平均住院时间和平均术后住院时间,分析这些因素对住院费用和住院时间的影响。结果:总计615例深部浸润型内异症患者纳入研究。深部浸润型内异症患者的平均住院费用显著高于其他内异症病例(8181元vs 7713元,P=0.009),但是平均年龄、平均住院时间和平均术后住院时间却显著小于其他内异症病例(分别为34.3岁vs 37.6岁,5.7天vs 6.3天以及3.7天vs 4.3天,P均<0.001)。在众多影响因素中,仅不同手术方式之间的平均住院费用有显著统计学差异(P<0.001),保守手术费用最低,根治性手术费用最高。平均住院时间和平均术后住院时间受到多种因素影响,多因素分析显示,手术路径、手术方式和病理分型的影响最大(P均<0.001),腹腔镜手术、保守手术和单纯型的平均住院时间最短,开腹手术、根治手术和直肠型的平均住院时间最长。结论:手术路径、手术方式和病理分型是影响深部浸润型内异症手术治疗所需住院费用和住院时间的最重要的因素。
Objective: To study the cost of hospitalization, length of stay, postoperative hospital stay and its influential factors in surgical treatment of deep infiltrative endometriosis. Methods: According to the cases of deep infiltrative endometriosis registered at Peking Union Medical College Hospital from January 2000 to December 2009 and compared with different age (≤30, 31-40,> 40 Year), different periods (2000-2004, 2005-2009), different pathological types (simple type, fornix type and rectum type), different operation pathways (laparotomy and laparoscopic operation), different operation methods And radical / semi-radical surgery), average hospitalization costs, average length of stay and average length of stay after different types of factors such as other types of endometriosis were combined to analyze the impact of these factors on hospitalization costs and length of stay. Results: A total of 615 deep-invasive endometriosis patients were included in the study. The average hospitalization costs of patients with deep infiltrative endometriosis were significantly higher than those of other endometriosis cases (8181 vs 7713 yuan, P = 0.009), but the mean age, average length of stay and average length of stay after hospitalization were significantly less than those of other endometriosis (34.3 vs 37.6 years, 5.7 vs 6.3 days and 3.7 days vs. 4.3 days, P <0.001, respectively). Among the many influential factors, the average cost of hospitalization was significantly different between different surgical methods (P <0.001), the lowest was conservative surgery, and the highest was the cost of radical surgery. The average length of stay and average duration of postoperative hospital stay were affected by various factors. Multivariable analysis showed that the most influential factors were the path of operation, operation method and pathological classification (all P <0.001), laparoscopic surgery, conservative surgery and simple type The shortest hospital stay, laparotomy, radical surgery and rectal type of the longest average hospital stay. Conclusion: The path of operation, surgical approach and pathological classification are the most important factors that affect the hospitalization costs and length of stay required for surgical treatment of deep infiltrative endometriosis.