宫颈病变1145例临床分析

目的研究社区卫生服务中心医护人员对预防宫颈癌前病变和宫颈癌认识的不足之处，探讨适合对基层医护人员预防宫颈癌前病变和宫颈癌知识培训的重点内容和培训的主要对象。方法对上海市5家社区卫生服务中心的全科医生和护师，按1：1的比例进行问卷调查，内容包括宫颈癌前病变和宫颈癌的基础知识、一级预防知识、二级预防知识和人乳头瘤病毒相关的公共卫生宣教知识等四方面内容，共10道单选题。结果共回收有效问卷172份，答卷完全正确的有105份，占61.05%。四方面内容的回答正确率分别为100.00%、99.42%、64.53%和87.79%。5家社区卫生服务中心的医护人员以及≤ 35岁、36~45岁和≥ 46岁3个年龄段医护人员的答卷完全正确率差异均无统计学意义（P值均>0.05）；全科医生与护师、不同学历医护人员的答卷完全正确率差异均有统计学意义（P值均 < 0.05）。结论社区卫生服务中心的全科医生和护师对宫颈癌前病变和宫颈癌的二级预防知识，以及和人乳头瘤病毒相关的公共卫生知识尚有不足。护师和学历较低的医护人员是培训的主要对象。

Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008

ObjectiveTo study the deficiency of the medical staffs in street health service on the prevention of cervical intraepithelial neoplasia and cervical cancer and to explore the necessary key content of knowledge training fit for primary health care personnel in prevention of cervical cancer and precancerous lesions.MethodsA questionnaire survey was conducted among 172 medical staffs (the ratio of general practitioner and nurse was 1:1) in five community health service centers in Shanghai.The questionnaire was divided into four aspects, 10 multiple-choice questions.ResultsOf the 172 questionnaires, 105(61.05%) were completely correct in answer.Four aspects included the basic knowledge of cervical precancerous lesions and cervical cancer, primary prevention knowledge, secondary prevention knowledge and human papilloma virus related public health education, the correct answers for the above accounted for 100.00%, 99.42%, 64.53% and 87.79% respectively.There was no statistically significant difference in the percentage of complete correct answers among the five community health service centers(P>0.05) and among the three age groups:age ≤ 35 years, 36-45 years and ≥ 46 years(P>0.05) but there was between general practitioners and nurses (P < 0.05) and there was between master's degree, bachelor's/college's degree and technical secondary school's degree (P < 0.05).ConclusionThe general practitioner and nurse staffs in Shanghai community health service center need to update their knowledge of secondary prevention of cervical intraepithelial neoplasia and cervical cancer, and public health knowledge related to human papilloma virus.Nurses and low-degree medical staff have insufficient awareness of preventing precancerous lesions of the cervix and cervical cancer, they should be the main object of training.