摘要
目的：分析社区鼻咽癌高危个体或鼻咽癌患者对早期症状和危险因素的知晓率、认知行为，探讨社区对鼻咽癌高危个体的早期发现和治疗鼻咽癌的干预机制。方法对社区139344例常住人口每年进行1次鼻咽癌筛查。采用数字表法将鼻咽癌高危个体或鼻咽癌患者分为干预组69616例和对照组69728例。两组中鼻咽癌患者在确诊后均进行常规治疗。干预组由专职医师进行长期的预防、保健、医疗、康复、健康教育及心理干预，对照组仅进行一般教育干预。采用流行病学现场干预类研究方法，分析筛查对象关于鼻咽癌早期症状和危险因素的知晓率，以及筛查对象在社区干预前后的行为、知识和态度及对鼻咽活检的行为。结果干预后，干预组鼻咽癌高危个体的早期发现率为75．31％，对照组鼻咽癌高危个体的早期发现率为44．37％，两组差异有统计学意义（χ2＝5．32，P＜0．01）；干预组对鼻咽癌的早期症状和危险因素知晓率分别为89．34％和91．78％，对照组对鼻咽癌的早期症状和危险因素知晓率分别为42．17％和28．47％，两组差异均有统计学意义（χ2＝49．41和χ2＝83．59，均P＜0．01）；干预组对鼻咽癌的主要症状、危害、诊断标准、防治方法以及正确的饮食、运动和行为习惯的知晓率均高于对照组（χ2＝31．86，P＜0．05；χ2＝8．05，P＜0．05；χ2＝214．09，P＜0．01；χ2＝65．94，P＜0．01；χ2＝147．18，P＜0．01）；Logistic回归模型分析显示，社区干预在促进鼻咽癌高危个体的早期发现上具有显著效果（ OR＝1．45）。结论对鼻咽癌高危个体或鼻咽癌患者开展社区干预，可提高鼻咽癌高危个体的早期发现，并提高鼻咽癌患者的行为、知识、态度及生存质量。
Objective To analyze the effects of community-based intervention on improving early detection of individuals with high risk nasopharyngeal carcinoma and to explore the interventional mechanism of prevention and treatment in nasopharyngeal carcinoma.Methods Total of 139 344 residents of the Second Chinese Medicine Hospi-tal of Guangdong Province Hospital Community were detected per year.Individuals with high risk nasopharyngeal car-cinoma or nasopharyngeal carcinoma patients were divided into intervention group（69 616 cases） and control group （69 728 cases） according to the random number table.The two groups were given conventional treatment （radiothera-py,chemotherapy and surgery treatment） after diagnosed.The intervention group was interfered with long -term prevention,health care,medical care,rehabilitation,health education and psychological intervention by full-time phy-sician,while the control group was only treated by general education intervention.The awareness of early symptoms and the risk factor of nasopharyngeal carcinoma were analyzed.Additionally,the behavior,knowledge and attitude on nasopharyngeal carcinoma were detected before and after the intervention.Results Community-based intervention＆amp;nbsp;significantly improved the rate of early detection of nasopharyngeal carcinoma high-risk individuals （ 75.31% vs. 44.37%,χ2 =5.32,P〈0.01） .The awareness rates of major symptoms and the damage of nasopharyngeal carcinoma were 89.34%and 91.78%in the intervention group.In the control group,the rates were 42.17%and 28.47%.The differences of the two groups were significant（P〈0.05）.Additionally,the awareness of diagnosis standard and good habits were improved significantly in the intervention group compared with the control group（P〈0.01）.Our results showed that intervention changed the attitude and understanding of patients with nasopharyngeal carcinoma and improved the quality of life of patients with nasopharyngeal carcinoma.Conclusion Intervention increased the early diagnos
出处
《中国基层医药》
CAS
2016年第8期1121-1125,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
广东省科技计划项目（2004195）
关键词
鼻咽肿瘤
高危个体
社区干预
早期发现
效果研究
Nasopharyngeal neoplasms
High risk individuals
Community intervention
Early detec-tion
Effect study
