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中華公共衛生雜誌

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篇名 子宮切除盛行率的初探
卷期 14:6
作者 張?張菊惠顧淑芬胡幼慧
頁次 487-493
關鍵字 子宮切除盛行率卵巢切除HysterectomyPrevalenceOophorectomyTSCI
出刊日期 199512

中文摘要

     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。鄉鎮區則由全省隨機取樣三處:分屬花東地區、南部地區和桃竹苗地區, 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準化,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 %,花東地區其次為 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,全子宮切除與全子宮及單側卵巢切除的人數由 1984 年至 1993 年,約增加了一倍,單側卵巢切除,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,而進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。

英文摘要

     In order to understand the hysterectomy and oophorectomy rates as wellas the surgical trends of Chinese women in Taiwan, a community survey andhospital medical records examination has been studied. The community surveycovered 1300 women aged 40 to 60 years. There were 674 women from the Taipeimetropolitan area, 197 from southern Taiwan rural areas, 149 from Hualien countyin the east, and 280 from Hsinchu county in central Taiwan. The hospital medicalrecords came from the Obstetrics and Gynecology Department of one Teachinghospital in Taipei area.After age adjusted the community subjects, the hysterectomy rates were 10.1% inTaipei, 9.5% in Hualien, 8.1% in Hsinchu county, and 6.4% in the southern Taiwanrural area. The oophorectomy rates were from 5.4% to 2.6%. After examining themedical records from 1984 to 1993, the number of removals of the whole uterus in1993 was double the number of removals in 1984 (from 600 to 1200). The number ofpartial 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 theuterus remained constant. It is suggested that largescale studies of theprevalence of hysterectomies are needed. Further studies on related factors ofhysterectomy, especially from the policy viewpoint of preventing malpractice andde-medicalizing physician-patient interactions, are also recommended.

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