EFFECTIVENESS AND OUTCOMES OF HYSTERECTOMY

子宫切除术是美国第二常见的大手术。 国家，仅次于剖腹产。美国37%的女性 60岁或以上的美国人曾做过子宫切除术。估计 子宫切除术的并发症发生率从20%到50%不等，包括 手术和术后出血，伤口感染，膀胱炎和 相关感染和对邻近器官的外科损伤。更长期的 后果包括性功能障碍，抑郁，疲劳，眩晕， 睡眠问题，排尿和肠道问题。黑人女性拥有更高的 子宫切除率、更高的并发症发生率和两倍的死亡率 这一比率高于接受子宫切除术的白人妇女。该计划的目标 建议的研究是为了解决文献中的几个空白 子宫切除术。这些目标是1。)进行为期2年的前瞻性调查 对马里兰州1,000名接受子宫切除术的妇女的研究 手术前和术后5个时间点的病人访谈 (3、6、12、18和24个月)，以及病历回顾和医生 面谈，以审查决策过程和结果 子宫切除术关注死亡率、发病率、健康状况、功能 能力和生活质量，2。)为了检查外科手术的程度 手术方式(阴道与腹部)和卵巢摘除会影响结果，3.至 检查患者种族和其他社会经济因素的程度 影响子宫切除术的决策过程和结果。

Hysterectomy is the second most frequent major surgery in the United States, second only to cesarean section. Thirty-seven percent of women in the United States aged 60 or over have had a hysterectomy. Estimates of the complication rate for hysterectomy range from 20% to 50% and include operative and postoperative hemorrhage, wound infection, cystitis and associated infections and surgical damage to adjacent organs. Longer term consequences include sexual dysfunction, depression, fatigue, vertigo, sleeping problems and urinary and bowel problems. Black women have higher rates of hysterectomy, higher complication rates and twice the mortality rate than for White women undergoing hysterectomy. The objectives of the proposed study are to address several gaps in the literature as concerns hysterectomy. These objectives are 1.) To conduct a 2 year prospective study of 1,000 women receiving hysterectomy in the State of Maryland, with patient interviews prior to surgery and at 5 points in time after surgery (3, 6, 12, 18, and 24 months), as well as chart review and physician interview, in order to examine the decision making process and outcomes of hysterectomy focusing on mortality, morbidity, health status, functional capacity, and quality of life, 2.) to examine the extent to which surgical procedure (vaginal vs abdominal) and ovary removal affect outcomes, 3.) to examine the extent to which patient race and other socioeconomic factors affect the decision making process and outcomes of hysterectomy.