EFFECTIVENESS AND OUTCOMES OF HYSTERECTOMY

子宫切除术是美国第二常见的大手术 美国，仅次于剖腹产。 37%的女性 美国60岁或以上的人曾接受过子宫切除术。 估计 子宫切除术并发症发生率从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手术损伤。 长期 后果包括性功能障碍、抑郁、疲劳、眩晕， 睡眠问题和大小便问题。 黑人女性更高 子宫切除率高，并发症率高，死亡率高一倍 比白色妇女行子宫切除术。 的目标 拟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年的前瞻性研究 在马里兰州对1,000名接受子宫切除术的妇女进行了研究， 术前和术后5个时间点的患者访谈 （3、6、12、18和24个月），以及病历审查和医生 面试，以检查决策过程和结果 子宫切除术，重点关注死亡率、发病率、健康状况、功能 （2）生活质量;）来检查外科手术 手术（阴道与腹部）和卵巢切除影响结果，3.）到 检查患者种族和其他社会经济因素 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.