Wilcox L S, Koonin L M, Pokras R, Strauss L T, Xia Z, Peterson H B
Program Services and Development Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
Obstet Gynecol. 1994 Apr;83(4):549-55. doi: 10.1097/00006250-199404000-00011.
To describe patient characteristics and diagnoses associated with hysterectomy in the United States from 1988-1990 using data from the National Hospital Discharge Survey.
We analyzed data from the National Hospital Discharge Survey, an annual probability sample of discharges from nonfederal, short-stay hospitals in the United States. A population-based sample of all women aged 15 years or older in the United States civilian population who had a hysterectomy during 1988-1990 was examined to characterize factors associated with hysterectomy: patients' age and race, diagnoses, surgical approach, and oophorectomy.
Approximately 1.7 million women had a hysterectomy during 1988-1990. The highest rates--100.5 hysterectomies per 10,000 women--were for women aged 30-54 years. Total rates of hysterectomy for black women were similar to those for white women (61.7 and 56.5 per 10,000 women, respectively); uterine leiomyoma ("fibroid tumor") was reported as the primary diagnosis for 61% of black women and 29% of white women. Abdominal surgery was used for 75% of all hysterectomies. Concomitant bilateral oophorectomy was done for 37% of the women under 45 years old and 68% of the women 45 years or older.
Two-thirds of all hysterectomies for noncancerous conditions were performed for uterine leiomyoma or endometriosis--conditions that are most common before the age of menopause. Future assessments of the appropriateness of hysterectomy will require better understanding of these disorders. Continued monitoring of hysterectomy rates is critical to understanding the appropriate use of hysterectomy, alternative therapies for uterine disorders, and future trends in women's health care.
利用国家医院出院调查的数据，描述1988 - 1990年美国子宫切除术相关的患者特征和诊断情况。
我们分析了国家医院出院调查的数据，该调查是对美国非联邦短期住院医院出院情况的年度概率抽样。对1988 - 1990年期间接受子宫切除术的美国15岁及以上平民女性进行基于人群的抽样调查，以确定与子宫切除术相关的因素：患者年龄和种族、诊断、手术方式以及卵巢切除术。
1988 - 1990年期间约有170万女性接受了子宫切除术。30 - 54岁女性的子宫切除率最高，为每10000名女性中有100.5例。黑人女性的子宫切除总率与白人女性相似（分别为每10000名女性中有61.7例和56.5例）；61%的黑人女性和29%的白人女性报告子宫平滑肌瘤（“纤维瘤”）为主要诊断。75%的子宫切除术采用腹部手术。45岁以下女性中有37%、45岁及以上女性中有68%同时进行了双侧卵巢切除术。
三分之二的非癌性疾病子宫切除术是因子宫平滑肌瘤或子宫内膜异位症进行的，这些疾病在绝经前最为常见。未来对子宫切除术适宜性的评估需要更好地了解这些疾病。持续监测子宫切除率对于理解子宫切除术的合理使用、子宫疾病的替代疗法以及女性医疗保健的未来趋势至关重要。
