The Importance Of Follow-up In The Diagnosis And Treatment Of Endometriosis

Object:Exploring the role of follow-up in the management of endometriosis based on endometriosis-specific training in Jiangxi Province.Method:The study used a prospective cross-sectional survey method to conduct a 7-day questionnaire survey via the We Chat platform to 20 We Chat groups of obstetricians and gynecologists in January 2020 and June 2022 respectively,in order to understand the current stage of diagnosis and treatment of endometriosis.This survey was completed voluntarily and included all medical institutions at all levels that can offer gynecology outpatient clinics and perform endometriosis-related surgery in Jiangxi Province Obstetricians and gynecologists.A 2-year training course on the management of endometriosis was conducted between the two surveys.The questionnaire data were statistically processed using SPSS25.0 software.Results:A total of 1278 valid questionnaires were included in the study,from obstetricians and gynecologists in 11 localities,distributed to a total of 650 in tertiary hospitals and 628 in secondary and lower hospitals.The results of two questionnaire surveys showed that tertiary hospitals compared with secondary and lower hospitals,there has more endometriosis outpatient clinics(14%vs1%,22%vs7%,P < 0.01),and the proportion of monthly outpatient visits > 15 was higher(9%vs4%,30%vs23%,P < 0.05),the proportion of monthly operation volume > 15 was higher(3%vs0.5%,24%vs9%,P < 0.05),the number of highly effective progesterone in drug selection was higher(29%vs21%,50%vs45%,P <0.05),and the number of people who actively developed and implemented long-term management was higher(23%vs12%,31%vs19%,P < 0.05),higher follow-up rate (65%vs45%,95%vs83%,P < 0.05),higher health education implementation rate(6%vs2%,21%vs9%,P < 0.05),lower recurrence rate(18%vs28%,16%vs22%,P <0.05),In 2022,there was a higher reading rate of "Guidelines for Diagnosis and Treatment of endometriosis(3rd Edition)"(28%vs22%,P < 0.01),and the above differences were statistically significant.According to Pearson correlation analysis,the follow-up rate in tertiary hospitals was negatively correlated with the recurrence rate(r=-0.43,-0.87,P < 0.01),and the follow-up rate in secondary and lower hospitals was negatively correlated with the recurrence rate(r=-0.26,-0.64,P < 0.01).Compared with the data in 2022 and 2020,the number of outpatient services for endometriosis increased significantly(29%vs15%,P < 0.01),the proportion of monthly outpatient treatment > 15 patients increased significantly(53%vs13%,P <0.01),and the proportion of monthly operation > 15 patients was higher(33%vs4%,P< 0.01).There was a significant increase in the proportion of oral drugs(including progesterone and oral contraceptives)in long-term drug management regimens(95%vs50%,P < 0.01;91%vs54%,P < 0.01);The follow-up rate of patients was significantly improved(89%vs55%,P < 0.01).The proportion of health education in the follow-up was significantly increased(30%vs8%,P < 0.01);The recurrence rate of patients was significantly decreased(23%vs19%,P < 0.01),and the above differences were statistically significant.By Pearson correlation analysis,the follow-up rate in 2020 was negatively correlated with the recurrence rate(r=-0.38,P< 0.01),and the follow-up rate in 2022 was negatively correlated with the recurrence rate(r=-0.58,P < 0.01).Conclusion:1 Endometriosis-specific training can improve physicians’ subjective knowledge of endometriosis and help them to develop good awareness of disease management;2 Long-term management,medication and health education for patients with endometriosis,based on effective follow-up,are beneficial in controlling recurrence of endometriosis;3 Regular follow-up has an important role in the management of endometriosis.