广东地区围绝经期妇女健康状况和需求调查

Survey of health status and healthcare service demand of perimenopausal women in Guangdong

目的了解广东地区围绝经期妇女的健康状况和健康需求,从而进一步探索围绝经期、老年期保健模式和方法,为政府部门提供决策依据.方法采取分层整群抽样的方法,将广东省按地理地貌分为5层,共抽取了5个地级市(代表城市)和4个县级市(代表农村).对40～65岁的4 500个围绝经期妇女进行调查.结果广东地区妇女自然绝经年龄48.6岁,其中城市48.9岁、农村48.3岁.现患病率39%,其中城市38.5%、农村39.5%,两者比较无显著性差异.前6位现患疾病的顺位是骨关节疾病(12.5%)、高血压(9.2%)、子宫肌瘤(6.8%)、胃或十二指肠溃疡(5.2%)、心脏病(2.7%)和糖尿病(2.2%).骨关节疾病中膝关节疾病(34.3%)、腰椎疾病(32.8%)是高发病,骨折患病率2.5%.围绝期综合征的患病率为68.1%,最为痛苦的症状是失眠、肌肉骨关节疼痛、烦躁、头晕,以心理症状(86.8%)和躯体症状(86.0%)为主;出现围绝经期综合征未就医者占71.2%,到妇产科就医者仅20.5%,以服用中药为主(53.9%),应用性激素疗法者1.4%(城市1.8%、农村1.0%).无健康体检者37.8%,有过健康体检者62.2%,其中城市80.4%、农村44.4%,城市明显高于农村.结论围绝经期综合征及相关疾病严重地影响围绝经期妇女的身心健康,这一人群的保健、医疗存在广泛需求,应该全方位地进行防治.

Objective To understand the health status and healthcare service demand of perimenopausal women in Guangdong Province so as to explore the mode and methods for implementing climacteric and senectitude healthcare. Method Using the method of stratified and cluster sampling and according to the geographical features of Guangdong Province, we selected 4 500 perimenopausal women aged 40-65 years from 5 relatively small cities (representatives of the urban areas) and 4 counties (representatives of the rural areas) for this survey. Results The average age of natural menopause was 48.6 years in this cohort of women, and was 48.9 years in women from the urban areas and 48.3 years in those from the rural areas. The total incidence of diseases was similar in the urban and rural areas (38.5% vs 39.5%), accounting for an incidence of 39% in the total subjects. The 6 most prevalent diseases were bone and joint disease (12.5%), hypertension (9.2%), myoma of the uterus (6.8%), gastric or duodenal ulcer (5.2%), cardiac disease (2.7%) and diabetes mellitus (2.2%). In bone and joint disease, knee joint disease and lumbar vertebrae disease were the commonest (34.3% vs 32.8%), and the incidence of bone fracture was 2.5%. Perimenopausal syndrome had a prevalence rate of 68.1%, and the most distressful symptoms were sleeplessness, muscular, bone and joint pain, fidgety, dizziness, of which 86.8% were mental symptoms and 86.0% body symptoms. Women(71.2%) with perimenopausal symptoms received no medical treatment, and only 20.5% had ever sought medical care in the department of obstetrics and gynecology, often taking traditional Chinese medicines (53.9%). Only 1.4% of the symptomatic women received hormone therapy, the rate varied from 1.0% in the rural areas to 1.8% in the urban areas. Conclusion Perimenopausal syndrome and its related diseases severely affect the physical and mental health of perimenopausal women, who demand extensive healthcare services.