社区围绝经期妇女生殖道感染现状及干预评价

目的分析社区围绝经期妇女生殖道感染（RTIs）状况，评估综合干预效果，为建立和完善社区卫生服务体系提供基层资料。方法随机选取45—65岁925名围绝经期妇女为研究对象，采取临床筛查和问卷的形式，对生殖道感染的知识、态度和行为；RTIs症状；医疗费用、妇科检查、医疗技术水平、服务态度、保健服务及时性和便利性等进行调查。了解和分析其生殖道感染状况及其影响因素。应用方差和多因素Logistic的方法对数据进行统计分析。在基线调查的基础上，实施为期1年的社区综合干预。结果RTIs患病率为31．89％，依次为萎缩性阴道炎（9．30％）、宫颈炎（5．51％）、附件炎（4．97％）、外阴阴道假丝酵母菌病（4．54％）、慢性盆腔炎（3．78％）、滴虫阴道炎（292％）；经Logistic分析表明：年龄、不良卫生习惯和丈夫RTIs自觉症状是RTIs发生的危险因素，文化程度和公费医疗则是其保护因素。干预1年后，有关RTIs知识、态度、行为正确率及总患病率情况均有所改善（x2值分别为27．948、16．750、82．137、8．256，均P〈0．01）。结论重视围绝经期RTIs，加强社区综合干预，有助于改善围绝经期妇女的生活质量，提高健康水平。

Current status of reproductive tract infections in perimenopausai women and evaluation on intervention

Objective To analyze the situation of reproductive tract infections （RTIs） in perimenopausal women and evaluate the effects of comprehensive intervention, so as to provide basic information for establishing and improving community health service system. Methods By using random sampling method, 925 perimenopausal women aged 45-65 years were recruited for study. Clinical screening and questionnaires were used to investigate their knowledge, attitude and practice （KAP） on RITs, RTIs symptoms, medical cost, gynecological examination, medical technology level, service attitude and the immediateness and convenience of health care service. The infection status of reproductive tract and its influencing factors were analyzed. Chi-square test and multiple factor Logistic methods were used for data analysis. On the basis of the baseline investigation, community intervention was carried out for one year. Results The morbidity rate of RTIs was 31.89%. The main RTIs included atrophic vaginitis （9.30%） , cervicitis （5.51%）, appendagitis （4.97%） , Candida vaginitis （ 4.54% ）, chronic pelvic inflammatory disease （ 3.78% ） and Trichomonas vaginitis （ 2.92% ）. Logistic analysis showed that education and public health were protective factors, while age, poor health habits and husband＇ s RTIs symptoms were risk factors. There was significant improvement in knowledge, attitude, practice, and the incidence of RTIs after intervention （X2 value was 27. 948, 16. 750, 82. 137 and 8. 256, respectively, all P 〈 0.01 ）. Conclusion Paying more attention to RTIs in perimenopausal women and strengthening community health service can improve the quality of life and health level of perimenopausal women.