社区妇女宫颈病管理模式的探讨与应用

Application of Cervical Disease Management Model for Women in Communities

目的建立有效的社区妇女宫颈病随访管理网络。方法选择2016年1-12月在上海市同仁医院妇科门诊进行宫颈病筛查的周边社区已婚妇女1075例为干预组,同期的1075例已婚妇女为对照组,两组患者均接受TCT和HPV DNA检测进行宫颈病筛查。对筛查异常者,对照组采用传统电话通知就诊的宫颈病随访模式,干预组采用筛查、转诊、督促随访、健康教育及专业培训为一体的社区卫生服务中心-上级医院宫颈病随访管理模式。结果干预组宫颈病筛查异常者的6个月有效就诊率(91.70%)明显高于对照组(59.83%)(P<0.01)。干预组健康教育后宫颈病相关知识知晓率明显提高(P<0.01),对宫颈病随访管理模式的满意度各项评价指标均在90%以上。结论建立社区卫生服务中心-上级医院的宫颈病随访管理模式,可实现对社区妇女宫颈病的有效管理。

Objective To establish an effective follow-up management network for cervical diseases among women livingin communities. Methods Between January and December 2016, 1075 married women living in the surrounding communities whowere screened for cervical diseases in the Outpatient Department of Gynecology of Shanghai Tongren Hospital were selected andassigned to the intervention group, while another 1075 married women served as the control group. Both groups received TCT andHPV DNA tests to screen cervical diseases. For those with abnormal results of screening,the control group adopted the traditionalfollow-up mode of telephone notification, while the intervention group adopted the model of follow-up management in communityhealth service centers and higher-level hospitals, involving screening,referral,supervision, follow-up,health education and training. Results The effective rate of diagnosis at 6 months was significantly higher（91. 70%） in the intervention group than that ofthe control group（59. 83%）（P〈0. 01）. In the intervention group,the level of knowledge related to cervical diseases was significantly increased after education（P〈0. 01）, and rate of satisfication with the cervical disease follow-up model was over 90%.Conclusion A follow-up management model of cervical diseases in community health service centers and higher level hospitalshas been established, which can ensure the effective management of cervical diseases in community women.