| Objective:To investigate the relationship between social economic factors, Clinical characteristics and Treatment method S on cholecystolithiasis patients in northern Xinjiang region,so as to provide reference for further study on the possible causes of "unreasonable medical intervention".Methods:1.The objects of study are the GS hospitalized patients who were diagnosed by imaging examination and from 14 two level of first-class and above hospitals which distributed in northern Xinjiang region.Using a unified " Cholecystolithiasis Intervention Questionnaire " collection various data of patients by look up the hospitalized cases and telephone follow-up. The questionnaire data was logged in Epidata.All statistical analysis,which including the difference of constituent ratio in treatment modalities among different level hospital, different social economic factors and clinical factors, were peorfmred using SPSS software.2. To investigate the cognitions of the knowledge about the cholecystolithiasis in medical staffs and to compare the scores of different grade hospitals..Results:1.The proportions of cases who dealed with outpatient follow-up,drug treatment only, percutaneous transhepatic gallbladder drainage(PTGD) and cholecystectomy were 7.23%, 4.35%,1.52% and 86.90% in a total of 6184 cases,respectively.The proportion of surgery pattern about one stage operation, two stage operation,laparoscopic cholecystectomy(LC),open cholecystectomy,conversion to open surgery, open cholecystectomy and lithotomy with gallbladder preservation were 91.11%,8.89%, 89.17%, 1.38%,2.85% and 6.61% respectively.The surgery ratio in grade three hospitals was higher, follow-up observation ratio and drug treatment ratio were lower than those in grade two hospitals respectively(P<0.05), and there were no significance in PTGD between both(P>0.05). One stage operation ratio and LC ratio in grade three hospitals were higher,and the two stage operation rate, OC rate, turn to open surgery ratio were lower than those in grade two hospitals(P<0.05).2. Surgery ratio in Poor,medium and good in Educated level and economic level were 84.16%, 88.57%, 80.90%, 83.71%, 87.65%,and 86.88% respectively. Surgery ratios in groups which with medical insurance, family history,symptoms, complications, gallbladder stone diameter≥2cm, gallbladder polyps, non-function of gallbladder, course ≥10 years, chronic diseases and with need to open operations were 87.73%,91.95%, 96.90%, 79.43%,98.38%, 91.01%, 98.70%,94.50%,89.65% and 100.00% respectively. The ratios in groups of better economic level, cultural level higher, with medical insurance,with family history, with symptoms and complications, stone diameter≥2cm, course≤10 years, no n-function of gallbladder, with chronic diseases and need to open operation surgery were higher and those none(P < 0.05).3. Total Suitable treatment ratio was high: 95.10%, it was 92.43% in grade two hospital and 97.33% in grade three hospital. There are 98.66% suitable treatment ratio in grade two hospitals and 97.55% in grade three hospital in group of operation indications. The overall treatment ratio and suitable treatment ratio of operation indications group in grade three hospital were higher than those in grade two hospital(P<0.05). In non-operation indications group,there were 76.87% suitable treatment ratio in grade two hospital and 79.04% in grade three hospital, there were no significance each other(P>0.05). The suitable treatment ratios of operation indications group were higher than of non-operation indications group in both of grade two hospitals and grade three hospitals(P<0.05). The mean of scores in the grade three hospitals was 21.39±1.94 and it was 22.36±1.79 in the grade two hospitals,and there were significant deference between them(t=-3.293,P=0.001).Conclusion:1.Cholecystolithiasis patients mostly underwent surgical treatment in northern Xinjiang region. Laparoscopic cholecystectomy was the mainly way of cholecystectomy. one stage operation ratio was high and the ratio of conversion to open surgery was low.2.The selections of treatment modalities may be affected by the economic level, education level and whether had medical insurance or not.The most probably clinical factors of decide to operation were symptoms, complications,stone diameter≥2cm, gallbladder polyps, non-function of gallbladder, course≥10 years, chronic diseases and need to open operation.3.There were some unsuitable treatments of cholecystolithiasis in 14 hospitals located in northern Xinjiang.Suitable treatments was better in grade three hospitals than in grade two hospitals.It maybe due to doctors strictless obeied operation indications or didn’t master surgical indication well. 4. The cognition of the doctors and nurses about the knowledge of the cholecystolithiasis in the three grade hospitals was higher than that in grade two hospitals. |
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