10349例已婚妇女妇科普查结果分析

Analysis of the Results of the Gynecological General Survey on 10 349 Women

目的:了解中国妇女妇科健康状况,探索科学的妇科普查方法。方法:回顾分析2009年11月—2010年10月在复旦大学附属妇产科医院体检中心进行妇科普查的10349例已婚妇女的常规体格检查、盆腔B超检查、白带常规检查、宫颈细胞学检查(包括巴氏涂片法或新柏氏TCT法)等资料。部分妇女进行高危型人乳头状瘤病毒(HR-HPV)检测,HR-HPV阳性或TCT异常者进行阴道镜病理组织学检查。结果:10349例体检妇女中发现慢性宫颈炎2100例,患病率为21.8%;子宫肌瘤1371例,患病率为14.2%;乳腺病878例,患病率为8.5%;阴道炎420例,患病率为4.1%。在296例HR-HPV阳性或TCT异常者中发现宫颈上皮内瘤变56例,早期宫颈浸润癌4例。TCT异常组的宫颈上皮内瘤变发生率显著高于HR-HPV阳性组的上皮内瘤变发生率。结论:妇科普查能及时发现妇科常见病,TCT和HR-HPV联合检查有助于宫颈上皮内瘤变的早期诊断。

Objective：To investigate the health state of the Chinese women by gynecological general survey and to explore the scientific method of gynecological examination.Methods：We collected 10349 Chinese women who did gynecological examination in the Obstetrics and Gynecology Hospital of Fudan University from November 2009 to October 2010.The examination included physical examination,pelvic B-sonography,leucorrhea conventional check,cervical cytology（Pap smear or Thinprep cytologic test）.High-risk human papillomavirus（HR-HPV） was tested in part of the women.Women with HPV-positive or aberrant TCT were volunteered to be selected to do colposcopy and histopathological examination.Results：In all 10349 women, there were 2100 cases with chronic cervicitis（incidence：21.8%）,1371 cases with myoma of uterus（incidence：10.2%）,878 cases with mastosis（incidence：8.5%） and 420 cases with vaginitis（incidence：4.1%）.In 296 women with positive HPV or aberrant TCT results,we found 56 cases had cervical intraepithelial neoplasia（CIN） and 4 cases had early invasive cervical carcinoma. The incidence of CIN in populations with aberrant TCT results was much higher than that in the populations with HPV positive.Conclusions：Gynecological general survey can timely detect gynecological diseases.The combined test of TCT and PHV contribute to the early diagnosis of CIN.