Merrill Ray M
Department of Health Science, College of Health and Human Performance, Brigham Young University, Provo, UT 84602, USA.
Med Sci Monit. 2008 Jan;14(1):CR24-31.
To identify patterns and trends in hysterectomy from 1997 through 2005.
MATERIAL/METHODS: Analyses are based on hysterectomy prevalence data from the Behavior Risk Factor Surveillance System, hysterectomy incidence data from the National Hospital Discharge Survey, and population estimates from the US Census Bureau.
Hysterectomy rates significantly decreased 1.9% per year between 1997 and 2005 (-0.5% for ages 18-44, -3.1% for ages 45-64, and -5.0% for ages 65 years and older). The estimated annual decrease in rates was significant in the Northeast (-2.9%), Northwest (-1.7%), and South (-2.6%), but not in the West. For hysterectomies performed among women ages 18-44 years, the percentage in 1997-98 compared with 2004-05 resulting from leiomyoma (fibroids) decreased (31.4% vs. 26.9%), from uterine bleeding increased (14.6% vs. 25.2%), from endometriosis decreased (17.3% in vs. 16.2%), and from pain increased (10.4% vs. 11.7%); the most common procedure, total abdominal hysterectomy, decreased (65.0% vs. 60.5%), the second most common procedure, vaginal hysterectomy, decreased (32.0% vs. 30.7%), and the third most common procedure, subtotal hysterectomy, increased (1.6% in 1997-98 and 7.5% in 2004-05). Decreases in hysterectomy rates occurred for most of the reproductive health conditions resulting in hysterectomy. Exceptions included pain and bleeding in the age group 18-44 and bleeding in the age group 45-64. An increase occurred in subtotal abdominal hysterectomy rates in each of the age groups.
Continued monitoring of hysterectomy rates provides an indication of female reproductive health and how women are being treated for selected reproductive problems.
确定1997年至2005年子宫切除术的模式和趋势。
材料/方法：分析基于行为危险因素监测系统的子宫切除术患病率数据、国家医院出院调查的子宫切除术发病率数据以及美国人口普查局的人口估计数。
1997年至2005年期间，子宫切除术率每年显著下降1.9%（18至44岁年龄段下降0.5%，45至64岁年龄段下降3.1%，65岁及以上年龄段下降5.0%）。东北部（-2.9%）、西北部（-1.7%）和南部（-2.6%）的子宫切除术率估计年下降幅度显著，但西部不显著。在18至44岁女性中进行的子宫切除术中，1997 - 1998年与2004 - 2005年相比，因平滑肌瘤（纤维瘤）导致的子宫切除术百分比下降（31.4%对26.9%），因子宫出血导致的百分比上升（14.6%对25.2%），因子宫内膜异位症导致的百分比下降（17.3%对16.2%），因疼痛导致的百分比上升（10.4%对11.7%）；最常见的手术方式，全腹子宫切除术下降（65.0%对60.5%），第二常见的手术方式，阴道子宫切除术下降（32.0%对30.7%），第三常见的手术方式，次全子宫切除术上升（1997 - 1998年为1.6%，2004 - 2005年为7.5%）。导致子宫切除术的大多数生殖健康状况下，子宫切除术率都有所下降。例外情况包括18至44岁年龄组的疼痛和出血以及45至64岁年龄组的出血。各年龄组次全腹子宫切除术率均有所上升。
持续监测子宫切除术率可为女性生殖健康以及针对特定生殖问题如何治疗女性提供指示。
