主动与全程管理和服务模式在妇女“两癌”防治中的应用

Active and integrated management and service mode for preventing and controlling ＂two cancers＂ of women

目的 通过计生、卫生部门合作,利用各自资源优势互补,建立主动与全程管理和服务的“两癌”防治工作模式.方法 通过计生网络,利用查环查孕时机和深入村居的方式进行育龄群众对“两癌”防治的知识的问卷调查,同时加大教育宣传和动员力度,促使适龄妇女自愿到医疗保健机构参与“两癌”普查普治;利用妇幼保健机构的优质医疗资源进行“两癌”技术筛查,普查采用常规妇科检查、宫颈脱落细胞巴氏涂片和乳腺手检与乳腺彩超检查相结合,可疑者作进一步检查的方法.结果 通过计生网络功能,在宣传发动上取得了较大优势,年龄覆盖较广,直接影响群众对“两癌”防治知识知晓率、普查参与率和“两癌”早诊断率.经过3年主动和全程服务管理后,管理对象的知晓率、普查参与率、早诊断率由65.40％、44.03％和52.96％,分别上升到86.20％、71.34％和73.37％,差异有统计学意义（P＜0.01）.结论 采用计生、卫生联合主动与全程管理和服务的“两癌”防治工作模式,群众“两癌”防治知晓率、参与率、早诊断率都比单纯妇幼部门开展“两癌”筛查要高.因此,计生和卫生部门联合,主动与全程管理和服务的“两癌”防治工作模式是可行且值得广大农村地区推广的.

Objective Through cooperation between Guangdong Women and Children Hosptial and National Health and Family Planning Commission of the People＇ s Republic of China and by complementing each other＇ s advantages,to establish a work mode which can offer initiative and whole range management and service to prevent and treat women＇ s ＂ two cancers＆quot,including cervical cancer and breast cancer.Methods Taking the opportunity going deep among the villagers to check contraceptive device and test pregnancy for them and with the help of the website of family planning,we conducted a questionnaire survey of preventing and treating ＂two cancers＂ on fertiel women.Besides,we devoted great effort to make propaganda and instruction for women＇ s ＂two cancers＂ among the villagers and let them go to health care organizations for general investigation and therapy on their own will.Taking advantage of the high quality medical resources of maternity and child care institution,we provided the villagers with several examinations in order to early diagnose women＇s ＂two cancers＂.Gynecologic examination and cervical scraping smear are widely used in predicting and diagnosing cervical cancer.Breast examination and color Doppler ultrasound are valuable diagnosis methods on breast cancer.Suspect cases of women＇s ＂two cancers＂ should be further examined.Results Website of family planning plays a cruicial role in achieving greater advantage of propaganding and educating the masses about ＂two cancers＂.The ages of the participants that involled in this project cover a wide range.This work pattern directly influenced the awareness rate,census participation rate,early diagnosis rate,and early intervention rate among the masses.After the whole course and initiative management and service mode for three years,the awareness rate,census participation rate,early diagnosis rate increased from 65.40%,44.03%,and 52.96% to 86.20%,71.34%,and 73.37%,with statistical differences（P 〈 0.01）.Conclusions Comparing with simply lauching women＇ s ＂two cancers＂ screening in maternity and child care institution,this new work pattern made the awareness rate,census participation rate and intervention rate among the masses higher.It is practicable and is worth being generalized in country side.