645例育龄期妇女孕前妇科疾病检出状况及影响因素的分析

Analysis of the detection status and influencing factors of gynecological diseases in 645 cases of pre-pregnancy

目的探讨育龄期妇女孕前体检常见妇科疾病检出情况及影响因素。方法选择2019年1月至2019年10月在杭州市妇产科医院体检中心进行孕前体检的645例育龄期女性职工作为研究对象,填写《个案体检表登记相关信息》,并行妇科常规、白带常规检查、薄层液基细胞学检测(TCT)、乳腺B超、子宫及附件B超检查。分析比较常见妇科疾病检出率及影响因素。结果645例研究对象中宫颈疾病中宫颈柱状上皮异位的检出率最高(13.18%),其次为宫颈纳氏囊肿(5.89%);乳腺疾病中乳腺增生的检出率高达72.71%;阴道炎检出率10.08%;子宫肌瘤检出率18.45%。年龄<30岁育龄妇女中宫颈柱状上皮异位检出率高于年龄≥30岁者(χ^2=9.11,P<0.01),而年龄<30岁育龄妇女中宫颈纳氏囊肿、乳腺增生、乳腺结节的检出率低于年龄≥30岁者(χ^2值分别为5.32、10.21、5.18,均P<0.05);宫颈纳氏囊肿、乳腺增生、阴道炎及子宫肌瘤检出率在不同职业间均有统计学差异(χ^2值分别为18.47、31.63、11.94、59.54,均P<0.05);常见妇科疾病的Logistic多因素回归分析结果显示:年龄<30岁、阴道炎、流产史、吸烟、口服避孕药是宫颈疾病的独立危险因素(均P<0.05);初潮年龄<14岁、年龄≥30岁、临床一线医护、流产史是乳腺疾病的独立危险因素(均P<0.05);事业单位人员、分娩史、流产史、是阴道炎的独立危险因素(均P<0.05);痛经、临床一线医护、分娩史、流产史是子宫肌瘤的独立危险因素(均P<0.05)。结论育龄期妇女孕前乳腺增生检出率最高,其次为宫颈肌瘤、阴道炎,年龄、职业、分娩史、流产史等多个因素与上述疾病的发生相关,因此需要加强育龄期女性生殖健康知识宣传,提高其生殖健康保健意识。

Objective To explore the detection status of common gynecological diseases and influencing factors in pre-pregnancy physical examination of women of childbearing age.Methods From January 2019 to October 2019,a total of 645 female employees of childbearing age who underwent pre-pregnancy physical examination in the physical examination center of Hangzhou Obstetrics and Gynecology Hospital were selected as the research objects.The relevant information of case physical examination from registration was filled in,and routine examination of gynecology,leucorrhea,thin layer liquid-based cytology(TCT),breast B-ultrasound,uterus and accessories B-ultrasound examination were performed.Analysing and comparing the detection rate and influencing factors of common gynecological diseases.Results The detection rates of cervical columnar epithelial ectopic cervical disease among 645 subjects was the highest(13.18%),followed by cervical nasal cyst(5.89%).The detection rate of breast hyperplasia in breast diseases was as high as 72.71%,the detection rate of vaginitis was 10.08%,and the detection rate of uterine fibroids was 18.45%.The detection rate of cervical columnar epithelium in women of childbearing age<30 years was higher than that in women of childbearing age≥30 years(χ^2=9.11,P<0.01),while the detection rates of cervical nasal cysts,breast hyperplasia,and mammary glands in women of childbearing age<30 years were lower than that in women of childbearing age≥30 years(χ^2=5.32,10.21 and 5.18,respectively,all P<0.05).The detection rates of cervical nasal cyst,breast hyperplasia,vaginitis and uterine fibroids were statistically different among different occupations(χ^2=18.47,31.63,11.94 and 59.54,respectively,all P<0.05).The logistic multivariate regression analysis of common gynecological diseases showed that age<30 years,vaginitis,history of miscarriage,smoking,and oral contraceptives were independent risk factors for cervical disease(all P<0.05);menarche age<14 years old,age≥30 years old,clinical first-line medical care,and abortion history were independent risk factors for breast disease(all P<0.05);personnel in public institutions,history of childbirth,history of miscarriage were independent risk factors for vaginitis(all P<0.05);dysmenorrhea,clinical first-line medical care,history of childbirth,and history of miscarriage were independent risk factors for uterine fibroids(all P<0.05).Conclusion The detection rate of breast hyperplasia before pregnancy is the highest in women of childbearing age,followed by cervical fibroids and vaginitis.Multiple factors,such as age,occupation,history of childbirth,history of miscarriage and other factors are related to the occurrence of the above diseases.Therefore,it is necessary to strengthen the propaganda of female reproductive health knowledge and raise their awareness of reproductive health care.