Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
Division of Obstetrics and Gynaecology, Södersjukhuset, Stockholm, Sweden.
BJOG. 2021 Apr;128(5):846-855. doi: 10.1111/1471-0528.16469. Epub 2020 Sep 6.
To evaluate how hysterectomy affects the prescription of analgesic, psychotropic and neuroactive drugs in women with endometriosis using population-based nationwide registers.
Nationwide cohort study.
Swedish national registers, from 1 January 2009 to 31 December 2018.
Women with benign disease undergoing a total hysterectomy during the 4-year period of 2012-2015. Women with endometriosis (n = 1074) were identified and compared with women who did not have endometriosis (n = 10 890).
Prospectively collected data from two population-based registers were linked: the Swedish National Quality Register of Gynaecological Surgery and the Swedish National Drug Register. Multivariate logistic regression was used as the main statistical method.
Changes in drug prescription over time for 3 years prior to and 3 years after hysterectomy.
The frequency of prescription of analgesics was higher in women with endometriosis compared with women without endometriosis (OR 2.2, 95% CI 1.7-2.9). Among women with endometriosis, the prescription of analgesics (OR 1.0, 95% CI 0.8-1.2) did not decrease 3 years after hysterectomy compared with the 3 years prior to surgery. There was also a significantly higher rate of prescription of psychoactive (OR 1.6, 95% CI 1.4-2.0) and neuroactive drugs (OR 1.9, 95% CI 1.3-2.7) in the long term postoperatively.
In women undergoing hysterectomy, endometriosis was associated with a higher prescription rate of analgesics. In the endometriosis group the prescription of analgesic, psychoactive and neuroactive drugs did not decrease when comparing prescription rates for the 3 years prior to and the 3 years after surgery.
In women with endometriosis, the long-term prescription of analgesics did not decrease after hysterectomy.
使用基于人群的全国性登记处评估子宫切除术对子宫内膜异位症女性的阿片类药物、精神药物和神经活性药物处方的影响。
全国性队列研究。
瑞典国家登记处，2009 年 1 月 1 日至 2018 年 12 月 31 日。
2012-2015 年期间接受全子宫切除术的良性疾病女性。确定患有子宫内膜异位症的女性（n=1074 人）并与没有子宫内膜异位症的女性（n=10890 人）进行比较。
从两个基于人群的登记处收集前瞻性数据进行链接：瑞典国家妇科手术质量登记处和瑞典国家药物登记处。主要统计方法是多变量逻辑回归。
子宫切除术前 3 年和术后 3 年内药物处方的变化。
与没有子宫内膜异位症的女性相比，患有子宫内膜异位症的女性使用阿片类药物的频率更高（比值比 2.2，95%置信区间 1.7-2.9）。在患有子宫内膜异位症的女性中，与手术前 3 年相比，子宫切除术后 3 年内阿片类药物的处方（比值比 1.0，95%置信区间 0.8-1.2）并未减少。长期术后精神药物（比值比 1.6，95%置信区间 1.4-2.0）和神经活性药物（比值比 1.9，95%置信区间 1.3-2.7）的处方率也明显更高。
在接受子宫切除术的女性中，子宫内膜异位症与更高的阿片类药物处方率相关。在子宫内膜异位症组中，与手术前 3 年相比，手术后 3 年内阿片类药物、精神药物和神经活性药物的处方率并未减少。
在患有子宫内膜异位症的女性中，子宫切除术后长期使用阿片类药物的情况并未减少。
