Wu Jennifer M, Wechter Mary Ellen, Geller Elizabeth J, Nguyen Thao V, Visco Anthony G
Department of Obstetrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Obstet Gynecol. 2007 Nov;110(5):1091-5. doi: 10.1097/01.AOG.0000285997.38553.4b.
To estimate hysterectomy rates by type of hysterectomy and to compare age, length of stay, and regional variation in type of hysterectomy performed for benign indications.
We conducted a cross-sectional analysis of national discharge data using the 2003 Nationwide Inpatient Sample. These data represent a 20% stratified sample of U.S. hospitals. Women aged 16 years or older who underwent a hysterectomy were identified by International Classification of Diseases, 9th Revision, Clinical Modification procedure codes. We extracted data regarding age, race, diagnoses codes, length of stay, and hospital characteristics. Using 2000 National Census data and weighted data analysis for cluster sampling, we calculated hysterectomy rates.
In 2003, 602,457 hysterectomies were performed, for a rate of 5.38 per 1,000 women-years. Of the 538,722 hysterectomies for benign disease (rate 4.81 per 1,000 women-years), the abdominal route was the most common (66.1%), followed by vaginal (21.8%) and laparoscopic (11.8%) routes. Mean ages (+/-standard deviation) differed among hysterectomy types (abdominal 44.5+/-0.1 years, vaginal 48.2+/-0.2 years, and laparoscopic 43.6+/-0.3 years, P<.001). Mean lengths of stay (+/-standard deviation) were also different (3.0+/-0.03 days, 2.0+/-0.03 days, 1.7+/-0.03 days, respectively, P<.001). The hysterectomy rate was highest in the South (5.92 per 1,000 women-years) and lowest in the Northeast (3.33 per 1,000 women-years).
Despite a shorter length of stay, vaginal and laparoscopic hysterectomies remain far less common than abdominal hysterectomy for benign disease.
III.
按子宫切除术类型估算子宫切除率，并比较因良性指征行子宫切除术患者的年龄、住院时间及手术类型的地区差异。
我们使用2003年全国住院患者样本对全国出院数据进行横断面分析。这些数据代表美国医院20%的分层样本。通过国际疾病分类第九版临床修订版手术编码识别16岁及以上接受子宫切除术的女性。我们提取了有关年龄、种族、诊断编码、住院时间和医院特征的数据。利用2000年全国人口普查数据和整群抽样的加权数据分析，我们计算了子宫切除率。
2003年，共进行了602457例子宫切除术，每1000妇女年的发生率为5.38例。在538722例因良性疾病行子宫切除术的患者中（每1000妇女年发生率为4.81例），经腹途径最为常见（66.1%），其次是经阴道途径（21.8%）和腹腔镜途径（11.8%）。不同子宫切除术类型的平均年龄（±标准差）有所不同（经腹44.5±0.1岁，经阴道48.2±0.2岁，腹腔镜43.6±0.3岁，P<0.001）。平均住院时间（±标准差）也不同（分别为3.0±0.03天、2.0±0.03天、1.7±0.03天，P<0.001）。子宫切除率在南部最高（每1000妇女年5.92例），在东北部最低（每1000妇女年3.33例）。
尽管经阴道和腹腔镜子宫切除术住院时间较短，但对于良性疾病，其仍远不如经腹子宫切除术常见。
III级。
