摘要
目的加强对妇科普查中发现可疑较重疾病患者的随访，增强妇女就医行为。方法从2008年7月起，上海市18个区妇幼保健所普查队对普查发现规定的可疑较重疾病进行了严格的随访，并督促其就诊直到有明确的诊断。上海市妇女保健所对2008年7月－2009年6月的随访报表进行了分析。结果总随访7487例，失访率为11．6％，被随访到妇女就医率为85．4％，最终确诊癌症150例。2008～2009年的普查报表显示子宫肌瘤、良性卵巢肿块、宫颈癌、卵巢癌、乳腺癌的发病率明显高于2007年。贫困和退休妇女的失访率显著低于在职妇女（10．7％VS18．6％Х^2=47．3908，P=0．000），但随访效果较在职妇女差（Х^2=59．7532，P=0．ooo）；城市地区的随访效果较农村地区差（r=206．2991，P=0．000）；拒诊率在不同年龄组间有显著差异（Х^2=45．9426，P=0．001）。若区妇幼保健所将随访工作下放到社区或受查单位，则可改变随访效果。结论普查中“重点对象随访”试行取得了一定的效果，优化工作方式可能进一步提高随访效果。
Objective To strengthen follow-up for women who were suspected to suffer from moderate or severe diseases found in gynecological diseases screening and to improve women＇ s behaviors in seeking medical advice. Methods From July in 2008, all MCH institutes in 18 districts in Shanghai conducted a strict follow-up for those women with suspected moderate or severe diseases according to rules in gynecological diseases screening and reminded these women to visit a doctor until they had definite diagnosis. The authors in Shanghai Women Health Institute analyzed the relevant report forms from July, 2008 to June, 2009. Results 7487 women were followed up, among which 11.6% of the women lost the follow-up. The rate of women seeking medical advice among those followed-up women was 85.4% and 150 women were diagnosed as malignancies eventually. The data on reports of screening of the MCH institutes in 18 districts in 2008 and 2009 showed that prevalence rates of hysteromyoma, benign ovarian tumors, cervical cancer, ovarian cancer and breast cancer in 2008 and 2009 were all significantly higher than in 2007. In poor or retired women, rate of loss the follow-up （ 10.7% vs 18.6% ; X^2 = 47. 3908, P = 0.000） was significantly lower than that in working women, but their follow-up effect was poorer than the working women （X^2 = 59. 7532, P = 0. 000）, The effect of follow-up in the urban areas was poorer than that in the rural areas （X^2 = 206. 2991, P = 0.000）. In resistance rate there was significant difference among different age groups （X2 = 45. 9426, P = 0. 001 ）. The effect of follow-up improved after the MCH institutes assigned their screening work to the community or subject units. Conclusion The trial implementation of follow-up for key women in gynecological diseases screening has achieved some effects and the effect of follow up could be improved further if the screening methods are optimized.
出处
《中国妇幼健康研究》
2011年第1期30-33,共4页
Chinese Journal of Woman and Child Health Research
关键词
妇科普查
随访
健康促进
评价
gynecological diseases screening
follow up
health promotion
evaluation
