某市农村不育症患病率现况调查及就医倾向浅析

目的了解银川市农村地区男性不育症患病现况及患者的就医倾向。方法随机选取1447名回、汉农村已婚男性进行婚育史及婚育现况调查,按年龄别进行分组（〉20岁、〉30岁、〉40岁）,其中回族637例,汉族810例。结果本次调查共检出27例男性不育症患者,总和不育率为1.59%（明显低于全国不育症的估计患病率）;其中回族男性不育率按年龄别划分分别为：〉20岁为1.27%、〉30岁为1.59%、〉40岁为1.71%,总和不育率为1.57%;汉族男性不育率按年龄别划分分别为：〉20岁为3.33%、〉30岁为1.95%、〉40岁为1.85%,总和不育率为2.10%（两者之间没有统计学差异）;约63%的患者未找到明确病因;患病后选择在二级以上公立医院就诊者约为51.85%,而选择在私人门诊就诊者约为48.15%,且这种倾向具有年龄偏向：年龄偏小者多倾向在二级以上公立医院就诊,而年龄偏大者更倾向于在私人门诊就诊（P〈0.01,有显著性差异）。结论地域环境与生活方式以及生活节奏的相对适宜是导致银川市农村男性不育发病率较低的主要原因;人口和计生系统应加强宣传教育,积极倡导健康生活理念,提高男性对健康生活方式的依从性,在改变不良行为、提高职业和环境的防护意识以及健全心理素质等多方面给予指导和帮助;建议广大公立医疗机构在不育症诊治领域加大宣传教育力度,在全社会倡导理性的不育症就医模式,建立科学的不育症临床诊治路径。

A Current Status of Infertility Prevalence and A Study on Medical Treatment Tendency of Rural A City

Objectives To investigate a current Status of infertility prevalence of rural Yinchuan City and a study on medical treatment tendency.Methods The Hui nationality（n=639） and the Han nationality（n=810）were divided into 3 age groups.（20 years;30 years;40 years）.To investigate obstetrical history and marriage and child rearing Current Status.Results The survey detected a total of 27 cases of male infertility patients,The sum of infertility was 1.59%（Significantly lower than the national estimates of the prevalence of infertility）;Hui male infertility rate,analyzed by age are as follows： 20 years of age was 1.27%,1.59% 30-year-old,1.71% 40-year-old,the sum of an infertility rate was 1.57%;Han male infertility rates by age division are as follows： 20 years of age was 3.33%,1.95% 30-year-old,1.85% 40-year-old,the sum of an infertility rate was 2.10%（no statistical difference between the two groups）;About 63% of the patients did not find a clear cause;About 51.85% patients tend to complete medical treatment in the two or up level public hospitals,and the choice in a private clinic clients was about 48.15%,this tendency do has age bias： small age tend to take two or up level public hospitals for treatment,while the older are more likely to tend in private outpatient visits（P 0.05,significant difference）.Conclusions The relative suitability of the geographical environment and the lifestyle and pace of life is the main reason leading to a lower incidence of rural male infertility of Yinchuan City.Population and family planning system should strengthen publicity and education to promote the concept of healthy living and to improve the adherence of men of a healthy lifestyle.In addition we should change the bad behavior,occupational and environmental protection awareness and improve the psychological quality,and many other provide guidance and assistance;We strongly recommend that the majority of public medical institutions should increase publicity and education efforts in the field of infertility diagnosis and treatment,advocating national infertility medical model in the whole society,and establishing clinical path of the scientific diagnosis and the treatment of infertility.