育龄女性下生殖道感染病原体的分布、危险因素及健康教育需求分析

Distribution of pathogens and risk factors for lower genital tract infections in women at childbearing age and needs of health education

目的调查育龄女性下生殖道病原体感染分布、危险因素,分析其健康教育需求。方法选取2015年6月-2016年2月医院自愿参加调查的育龄女性526例为研究对象,自行设计调查问卷,采用现场问卷调查方式,统计分析育龄女性下生殖道感染情况及病原体分布,对育龄女性下生殖道感染的相关因素实施单因素、多因素logistic分析,并进行相应的健康教育需求分析。结果育龄女性下生殖道感染率为39.9%(210/526),共分离出病原体368株,其中革兰阳性菌、革兰阴性菌、真菌、解脲脲原体、沙眼衣原体、滴虫分别占28.8%、24.5%、10.1%、28.5%、5.7%和2.4%;单因素分析结果显示,育龄女性下生殖道感染与年龄、文化程度、性行为、流产史和避孕方式呈明显相关性(χ2=5.034、7.336、4.561、10.056和6.213,P<0.05)。多因素logistic回归分析结果显示,文化程度和避孕方式是育龄女性下生殖道感染的独立危险因素(OR=3.689,6.597,P<0.05);广播是育龄女性现有获取知识的主要途径,占27.0%;育龄女性希望获取知识途径前三位的是网络平台、医务人员和广播,分别占41.3%、28.3%和14.4%。结论育龄女性下生殖道感染以革兰阳性菌为主,文化程度和避孕方式是其发生的独立危险因素,可针对危险因素和健康教育需求进行干预,以降低育龄女性下生殖道感染的发生。

OBJECTIVE To investigate the distribution of pathogens and risk factors for lower genital tract infections in women at childbearing age and analyze the needs of health education. METHODS From Jun 2015 to Feb 2016, a total of 526 women at childbearing age who voluntarily participated the survey were recruited as the study objects, the questionnaires were self-designed, the onsite questionnaire survey was conducted, the incidence of lower genital tract infection and distribution of pathogens were statistically analyzed, the univariate analysis and multivariate logistic analysis were performed for the related factors for the lower genital tract infection in the women at childbearing age, and the corresponding needs of health education were analyzed. RESULTS The incidence of lower genital tract infection was 39. 9% （210/526） in the women at childbearing age. A total of 368 strains of pathogens were isolated, of which 28.8 % were gram-positive bacteria, 24.5 % were gram-negative bac- teria, 10.1% were fungi, 28.5 % were Ureaplasma urealyticum, 5.7% were Chlamydia trachomatis, and 2.4 were Trichomonas. The result of univariate analysis indicated that the lower genital tract infection in the women at childbearing age was remarkably associated with the age, education level, sexual behavior, history of abortion, and contraception approach （χ^2=5. 034, 7. 336, 4. 561, 1 0. 056, and 6. 213,P〈0.05）. The result of the multivariate logistic regression analysis showed that the education level and contraception approach were the independent risk factors for the lower genital tract infection in the women at childbearing age （OR= 3. 689,6. 597, P〈0.05）.The broadcast was the major approach of the women at childbearing age to acquire knowledge, accounting for 27.0%; the network platform, health care workers, and broadcast were the top 3 approaches with which the women at childbearing age hoped to acquire knowledge, accounting for 41.3%, 28.3%, and 14.4%, respectively. CONCLUSION The gram-positive bacteria are dominant among the pathogens causing the lower genital tract infections in the women at childbearing age. The education levels and contraception approach are the independent risk factors. It is necessary to take interventions aiming at the risk factors and needs of health education so as to reduce the incidence of the lower genital tract infections in the women at childbearing age.