渝东南地区女性宫颈上皮内瘤变发生的危险因素分析

Analysis of risk factors for cervical intraepithelial neoplasia in Southeast Chongqing

目的探讨渝东南地区女性宫颈上皮内瘤变(CIN)发生的危险因素。方法选取2016年1月至2017年1月在重庆市黔江民族医院、重庆市黔江中心医院、重庆市黔江武黔医院、重庆市黔江东南医院妇产科就诊的CIN患者208例。对所有患者行高频点波刀宫颈环状电圈切除术,并进行问卷调查。调查内容包括患者年龄、性生活防护情况、初次性生活年龄、家庭经济状况、性伴数、受教育程度、性伴多性、口服避孕药情况、免疫抑制剂应用史、近期性传播疾病史、分娩方式、个人卫生状况、流产次数,以及吸烟、吸毒等,分析其对CIN的影响。结果术后高危人乳头瘤病毒(HPV)感染率明显低于术前,且差异有统计学意义(P<0.05);单因素分析表明,年龄≥40岁、性生活未避孕、初次性生活年龄≤20岁、家庭经济状况较差、性伴数≥3个、受教育程度低、性伴多性、口服避孕药、免疫抑制剂应用史、近期性传播疾病史、分娩方式为剖宫产、个人卫生状况差、流产次数≥2次、吸烟、吸毒差异具有统计学意义(P<0.05);将单因素分析中有统计学意义的指标纳入多因素回归分析表明,性生活未避孕、初次性生活年龄≤20岁、性伴多性、口服避孕药、吸烟为其独立危险因素。结论性生活未避孕、初次性生活年龄≥20岁、性伴多性、口服避孕药、吸烟为CIN独立危险因素,相关部门应加强健康教育,提高女性自我保健意识。

Objective To investigate the risk factors of cervical intraepithelial neoplasia(CIN)in Southeast Chongqing.Methods From January 2016 to January 2017,208 patients with CIN were selected from the department of obstetrics and gynecology,Qianjiang National Hospital,Chongqing Qianjiang Central Hospital,QianjiangWuqianHospital,Southeast Hospital of Qianjiang.The investigation included age,sexual life protection,the age of women′s first sex,family economic status,number of sexual partners,level of education,sexual partners,oral contraceptives,immunosuppressant application history,recent history of sexually transmitted diseases,mode of delivery,personal hygiene,abortion,smoking and drug use,and effect was analyzed on the CIN.Results After the operation,high-risk HPV infection rate was significantly lower than before(P<0.05).Single factor analysis showed that age higher than 40 years,non-contraception in sexual life,age of first sexual life lower than 20 years,poorer personal hygiene,lower family income,number of sexual partners more than three,lower level of education,more sexual partners,oral contraceptives,immunosuppressive therapy,recent history the spread of disease,cesarean section,personal hygiene,abortion,smoking and drug abuse were the influenced factors on CIN(P<0.05).And multivariate regression analysis showed that non-contraception in sexual life,age of first sexual life lower than 20 years,more sexual partners,oral contraceptives and smoking were the independent risk factors.Conclusion Non-contraception in sexual life,age of first sexual life lower than 20 years,more sexual partners,oral contraceptives and smoking are the independent risk factors for CIN.Relevant state departments should strength health education,so as to improve the awareness of self-health protection.