子宮切除盛行率的初探

本篇報告為子宮切除盛行率之初探，資料來源為社區婦女調查與醫院病歷資料。社區婦女調查分為都會區與鄉鎮區兩部份，都會區以大臺北為研究地區，訪視期間為1991年7-11月，共訪視674位40-60歲婦女。鄉鎮區則向全省隨機取樣三處，分屬花東地區、南部地區和桃竹訪地區，訪視期間為1992年1-4月，共訪視626位40-60歲婦女，花東地區149人，南部地區197人，桃竹苗地區280人。醫院資料以臺北某大型教學醫院1984-1993年病歷室登記子宮與卵巢切除資料做分析。將四個地區的切除率做年齡標凖化，以作都會區與鄉鎮區的比較。結果發現標準化後的子宮切除率以臺北地區最高為10.1%，花束地區其次為9.5%，南部地區最低為6.4%。卵巢切除率也是臺北地區最高為5.4%，其次為桃竹苗地區5.2%，最低的也是南部地區為2.6%。醫院方面，全子宮切除與全了宮及單側卵巢切除的人數由1984年至1993年，約增加了一倍，單側卯巢切除，約增加了一半。卵巢雙側切除則不變。國外關於子宮切除的探討已有二、三十年，內容超越單純的盛行率報導，而退一步分析盛行率與地理區分布、醫療資源分佈、病人人口特色、醫師特性等因素之相關性，以了解影響子宮切除的相關因素，更進而制訂相關衛生政策與監測系統以控制切除率。而國內在這方面仍闕如，日後需要投注更多研究與探討。

關鍵字

子宮切除；盛行率；卵巢切除

並列摘要

In order to understand the hysterectomy and oophorectomy rates as well as the surgical trends of Chinese women in Taiwan, a community survey and hospital medical records examination has been studied. The community survey covered 1300 women aged 40 to 60 years. There were 674 women from the Taipei metropolitan area, 197 from southern Taiwan rural areas, 149 from Hualien county in the east, and 280 from Hsinchu county in central Taiwan. The hospital medical records came from the Obstetrics and Gynecology Department of one Teaching hospital in Taipei area. After age adjusted the community subjects, the hysterectomy rates were 10.1% in Taipei, 9.5% in Hualien, 8.1% in Hsinchu county, and 6.4% in the southern Taiwan rural area, The oophorectomy rates were from 5.4% to 2.6%. After examining the medical records from 1984 to 1993, the number of removals of the whole uterus in 1993 was double the number of removals in 1984 (from 600 to 1200). The number of partial removals of the ovary increased from 300 in 1984 to 450 in 1993. However, the number of removals of both ovaries and partial removals of the uterus remained constant. It is suggested that large- scale studies of the prevalence of hysterectomies are needed. Further studies on related factors of hysterectomy, especially from the policy viewpoint of preventing malpractice and de-medicalizing physician-patient interactions, are also recommended.

並列關鍵字

Hysterectomy ； Prevalence ； Oophorectomy

國際替代計量

子宮切除盛行率的初探

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