Effectiveness of hysterectomy
Effectiveness of hysterectomy
复制标题
DOI：
10.1016/s0029-7844(99)00544-x
复制
发表时间：
2000-03-01
影响因子：
7.2
通讯作者：
Stolley, PD
中科院分区：
文献类型：
--
作者：
Kjerulff, KH;Langenberg, PW;Stolley, PD
目的：为了衡量子宫切除术在缓解不良症状的有效性，并确定与缺乏症状relief.Methods相关的因素：在一项为期2年的前瞻性研究中，数据收集前和3，6，12，18，24个月后子宫切除术在1299名妇女谁曾在马里兰州的28家医院的良性条件子宫切除术。有效性是根据症状的缓解来衡量的，如问题性阴道出血、盆腔疼痛和尿失禁。心理功能和手术前后的生活质量也进行了assessed.Results：症状的严重程度，抑郁和焦虑水平显着下降后子宫切除术和生活质量的改善，特别是在该地区的社会功能。然而，8%的妇女在子宫切除术后1年和2年至少有同样多的症状。在多元逻辑回归分析中，术前患者的一些特征预测了症状的缺乏缓解，包括情绪或心理问题的治疗，抑郁症，家庭收入35，000美元或更少。双侧卵巢切除术预测了子宫切除术后24个月症状的缺乏缓解，但在12个月时没有。子宫切除术后，健康状况的所有三个方面（症状、心理功能和生活质量）均得到显著改善，并在2年的随访中持续或继续改善。然而，子宫切除术并没有减轻一些妇女的症状，特别是那些低收入或在子宫切除术时正在接受治疗的妇女。（《妇产科》，2000年; 95：319- 326。(C)2000年由美国妇产科医师学会。
Objective: To measure the effectiveness of hysterectomy in relieving adverse symptoms and to identify factors associated with lack of symptom relief.Methods: In a 2-year prospective study, data were collected before and at 3, 6, 12, 18, and 24 months after hysterectomy in 1299 women who had hysterectomies for benign conditions at 28 hospitals across Maryland. Effectiveness was measured in terms of relief of symptoms such as problematic vaginal bleeding, pelvic pain, and urinary incontinence. Psychologic function and quality of life before and after surgery also were assessed.Results: Symptom severity, depression, and anxiety levels decreased significantly after hysterectomy and quality of life improved, :particularly in the area of social function. However, 8% of women had at least as many symptoms at problematic-severe levels 1 and 2 years after hysterectomy as before. In multiple logistic regression, several presurgical patient characteristics predicted lack of symptom relief, including therapy for emotional or psychologic problems, depression, and household income of $35,000 or less. Bilateral oophorectomy predicted lack of symptom relief at 24 months but not at 12 months after hysterectomy.Conclusion: Significant improvements were seen after hysterectomy for all three aspects of health status (symptoms, psychologic function, and quality of life), which persisted or continued to improve throughout the 2 years of follow-up. However, hysterectomy did not relieve symptoms for some women, particularly those who had low incomes or were in therapy at the time of hysterectomy. (Obstet Gynecol 2000; 95:319-26. (C) 2000 by The American College of Obstetricians and Gynecologists.).