青春期子宫异常出血的影响因素分析

Investigation and Analysis of Influence Factors on Abnormal Uterine Bleeding in Adolescents

目的探讨湖北省荆州地区青春期子宫异常出血的影响因素,为降低青春期子宫异常出血发生率提供流行病学数据。方法选择2012年11月至2013年5月在荆州地区13所中学随机抽取年龄为12-16岁的初中在校女生5 000名（受试者）及其所填写的问卷为研究对象。采用自行设计的《青春期女生月经情况和一般情况调查表》,对受试者的基本信息（年龄、家庭地址、身高、体质量）,月经情况（月经初潮时间、月经周期、月经量）及其他因素（居住环境、经期护理、健康状况）等内容进行调查。此外,另自行设计《心理因素对青春期子宫异常出血影响调查表》,对因心理因素导致青春期子宫异常出血单独进行问卷调查。结果本调查问卷共计发放5 000份,剔除436名月经未来潮者所填写的问卷,回收有效问卷4 564份,问卷有效回收率为91.28%。根据本研究设定的子宫异常出血判断标准,子宫异常出血者为2 177名（47.69%）,月经正常者为2 387名（52.31%）。不同居住环境女生的子宫异常出血发生率比较,差异无统计学意义（χ^2=4.08,P〉0.05）;青春期女生不同身体健康状况（经期是否有感染史、结核、其他疾病与无疾病）、经期护理情况（护理良好与护理不良）及心理因素得分（≥35分与〈35分）的子宫异常出血发生率比较,差异均有统计学意义（χ^2=13.39,12.82,10.43;P〈0.05）。健康状况、经期护理及心理压力是子宫异常出血的危险因素（OR=3.65,95%CI：2.53-4.34,P〈0.05;OR=0.97,95%CI：0.86-1.09,P〈0.05;OR=0.57,95%CI：0.33-0.64,P〈0.05）。结论适量运动、均衡营养、良好心态和经期护理得当均能促进女性生理卫生健康。

Objective To discuss the influence factors of abnormal uterine bleeding in adolescents in Jingzhou area,Hubei Province,in order to reduce the incidence rate of abnormal uterine bleeding in adolescents.Methods A total of 5 000 junior high school girls,aged 12-16 years old,were randomly chosen from 13 middle schools in Jingzhou area during November 2012 to May 2013.All of the 5 000 girls completed two self-designed questionnaires（Questionnaire on Menstruation Situation in Adolescent Girls and Influence of Psychological Factors on Abnormal Uterine Bleeding in Adolescents）.Questionnaire on Menstruation Situation in Adolescent Girls included the following items：general information（age,family address,body height and weight）,menstrual status（menarche age,menstrual cycle,menstrual period,menstrual quantity）,and other factors（living environment,menstrual nursing,health situation and nutrition）.Influence of Psychological Factors on Abnormal Uterine Bleeding in Adolescents mainly focused on psychological factors.Results A total of 5 000 questionnaires were distributed and 4 564 effective questionnaires were collected（436 girls without menstruation）.The effective rate of questionnaires was 91.28%.According to the questionnaire results,the incidence rate of abnormal uterine bleeding in adolescents was 47.69%（2 177/4 564）.There was no significant difference of incidence rates of abnormal uterine bleeding in adolescents among different living environments（χ^2=4.08,P〉0.05）.There were significant differences of incidence rates of abnormal uterine bleeding among different health situation,menstrual nursing and psychological pressure（χ^2=13.39,12.82,10.43;P〈0.05）.Health situation,menstrual nursing and psychological pressure were risk factors for abnormal uterine bleeding in adolescents（OR=3.65,95%CI：2.53-4.34,P〈0.05;OR=0.97,95%CI：0.86-1.09,P〈0.05;OR=0.57,95%CI：0.33-0.64,P〈0.05）.Conclusion Moderate exercises,balanced nutrition,good mentality and menstrual nursing can promote women′s reproductive health.