Institut für Klinische Epidemiologie, Medizinische Fakultät, Martin-Luther-Universität, Halle-Wittenberg, Deutschland.
Dtsch Arztebl Int. 2011 Jul;108(30):508-14. doi: 10.3238/arztebl.2011.0508. Epub 2011 Jul 29.
Hysterectomy is among the more common surgical procedures in gynecology. The aim of this study was to calculate population-wide rates of hysterectomy across Germany and to obtain information on the different modalities of hysterectomy currently performed in German hospitals. This was done on the basis of nationwide DRG statistics (DRG = diagnosis-related groups) covering the years 2005-2006.
We analyzed the nationwide DRG statistics for 2005 and 2006, in which we found 305 015 hysterectomies. Based on these data we calculated hysterectomy rates for the female population. We determined the indications for each hysterectomy with an algorithm based on the ICD-10 codes, and we categorized the operations on the basis of their OPS codes (OPS = Operationen- und Prozedurenschlüssel [Classification of Operations and Procedures]).
The overall rate of hysterectomy in Germany was 362 per 100 000 person-years. 55% of hysterectomies for benign diseases of the female genital tract were performed transvaginally. Bilateral ovariectomy was performed concomitantly in 23% of all hysterectomies, while 4% of all hysterectomies were subtotal. Hysterectomy rates varied considerably across federal states: the rate for benign disease was lowest in Hamburg (213.8 per 100 000 women per year) and highest in Mecklenburg-West Pomerania (361.9 per 100 000 women per year).
Hysterectomy rates vary markedly from one region to another. Moreover, even though recent studies have shown that bilateral ovariectomy is harmful to women under 50 who undergo hysterectomy for benign disease, it is still performed in 4% of all hysterectomies for benign indications in Germany.
子宫切除术是妇科中较为常见的手术之一。本研究旨在计算德国全国范围内的子宫切除术率，并获取德国各医院目前所施行的不同子宫切除术式的相关信息。这是基于涵盖 2005-2006 年的全国范围内的按疾病诊断相关分组（DRG = diagnosis-related groups）统计数据完成的。
我们分析了 2005 年和 2006 年的全国性 DRG 统计数据，其中我们发现了 305 015 例子宫切除术。基于这些数据，我们计算了女性人群的子宫切除术率。我们根据 ICD-10 编码制定的算法确定了每种子宫切除术的适应证，并根据 OPS 编码（OPS = Operationen- und Prozedurenschlüssel [操作和程序分类]）对手术进行分类。
德国的子宫切除术总体率为每 100 000 人年 362 例。55%的女性生殖道良性疾病子宫切除术经阴道施行。双侧卵巢切除术同时施行于所有子宫切除术的 23%，而 4%的子宫切除术为次全切除术。各联邦州之间的子宫切除术率差异很大：良性疾病的比率在汉堡最低（每 100 000 名女性每年 213.8 例），在梅克伦堡-前波美拉尼亚最高（每 100 000 名女性每年 361.9 例）。
子宫切除术率在不同地区之间差异显著。此外，尽管最近的研究表明，对于因良性疾病而接受子宫切除术的 50 岁以下女性，双侧卵巢切除术有害，但在德国，仍有 4%的良性适应证子宫切除术施行双侧卵巢切除术。
