Discussion On Management Model Of Cervical Precancerous Lesions In Zhongshan City

Objective:To analysis the situation and relevant factors for childbearing age women with cervix precancerous lesions in Zhongshan city.To explore a suitable and standardized management mode for cervix precancerous lesions in Zhongshan city.To evaluate the management mode which we explored.Methods:1.We adopt retrospective analysis to explore relevant factors of morbidity in childbearing age women with cervix precancerous lesions in Zhanshan city during 2011 to March 2015.2.Checking methods:routine gynecological examination and liquid based cytology,when the result was positive,further HPV test and colposcope examination were suggest,biopsy was choose when it was necessary.3.Information management:we used information system platform for women and children in Zhongshan city to enter medical records,established database of the crowd with CIN.To track the follow-up results,treatment and prognosis of patients,statistic follow-up rate4.Specific personnel management:established the center of cervical lesions,then set special nurses and doctors to implement.5.To improve the follow-up rate through the methods of health education:5.1 Questionnaire survey:inspect was adopt before and after the intervention investigation at the scene.5.2 Appointment for patients:spcial nurse would inform patients with telephone to attend health seminars half a month early5.3 Spceial lecture:a deputy director of the physician in cervical lesions center gave lesions,who was designated by Bo'ai Hospital in Zhongshan.Results:1.The incidence situation of cervix precancerous lesions in Zhongshan city.1.1 The incidence situation of cervix precancerous lesions in different age groups:44936 cases were general investigated during 2011,258 cases were detected with cervical cancer,the morbidity was 57.425 ‰.The morbidity of different groups were higher in those:66.53‰ in 45 and above,70.55 ‰ in 30 to 45,71.95‰ in 40 to 30,79.28 ‰ in 35 and below,which were lower in those:0 in 25 and below,46.09‰in 25 to 30?25.07‰ in 55 and above,13.27%in 50 to 55.Throug the two chi-square test,we found that the incidence between low and high groups,there was statistically significant difference between each other(P<0.05).1.2 The incidence situation of cervix precancerous lesions in different apartment.The incidence of precancerous lesions of uterine cervix in urban women was 52.61‰,rural women was 59.20 ‰.Through the two chi-square test,we found that the incidence of precancerous lesions of uterine cervix between rural and urban areas was no statistically significant difference(x2=0.687,p=0.440>0.05).1.3 cervical precancerous lesions in a variety of educational levels of the incidence of womenThe incidence of cervical cancerous lesions in different cultures.The high incidence of groups were university group(85.49 ‰),high school group(60.64 ‰),junior high school group(64.04 ‰),the low incidence groups were primary school group(41.96 ‰)and illiterate group(10.79 ‰),The high incidence groups and low incidence groups were compared by chi-square statistical analysis,P<0.05,was statistically significant.1.4.1 The incidence of cervical precancerous lesions in different occupationsThe highest incidence group which was the free occupational group(81.87 ‰)was compared with the lowest incidence of two groups which were.family women group(48.71 ‰)and the workers group(49.45 ‰)by chi-square statistical analysis,P<0.05,differences were statistically significant.Between Individual group 64.82 ‰,attendant group 67.84‰,company staff group 68.71‰ and civil servant or teacher group 73.89 ‰ by chi-square comparison,P>0.05,the differences were not statistically significant.1.5.1 Cervical precancerous lesions in different families per capita income.among the incidence of women<=250 yuan group 132.74 ‰,250-500 yuan group 64.62 ‰,500-1250 yuan group 72.01 ‰,>1250 yuan group 54.48 ‰.The incidence of precancerous lesions in different occupations was not different between the two groups by chi-square comparison,P>0.05,the difference was not statistically significant.2.management model:2.1 through the information platform to establish a database of cervical precancerous lesionsFrom March 2011 to March 2015,cervical cancer center established 1021 copies of electronic files for cervical precancerous lesions.2.2 Discussion on health education model of cervical precancerous lesions2.2.1 The attendance rate of health education lecture in cervical precancerous lesions patients341 cervical precancerous lesions were be informed by telephone to attend the meeting,ultimately 105 peopel attended the meeting,the rate of attending the meeting was 30.79%.2.2.2 cervical cancer health knowledge source approachPatients with cervical cancer health knowledge source of the main community health education,(71.43%).2.2.3 after intervention CIN patients with a significant increase in the level of knowledge,P<0.05,the difference was statistically significant.3.the management model assessment:the follow-up-rate increased after intervention 3 months(76.19%)than before intervention 6 months(19.05%)significantly.The follow-up-rate decreased after intervention 6 months(23.81%)than after intervention 3 months 80(76.19%)significantly,P<0.05 was statistically significant.Analysisconclusion:1.Women of cervical precancerous lesions management model is the information platform combined with health education management model in Zhongshan City.1.1 By the cervical disease center full-time nurses and doctors to establish electronic files,the use of Zhongshan City-maternal and child information system for system management.1.2the local women's federations and bstetrics and Gynecology experts organize of Health Education Lectures every six months,follow-up time every six months,a total of 2 years,normal annual follow-up.1.3Each follow-up content TCT liquid-based cytology and HPV detection,if necessary,colposcopy biopsy.2.Through the management model of the cervical cancer patients in Zhongshan City,The patient follow-up rate increased from 19.05%before implementation to 76.19%after implementation.The results of information technology platform health education management model can effectively improve the follow-up rate of cervical precancerous lesions.3.the focus of cervical disease prevention and control should be the age of 30-50 years old,the degree of education for the University(college),high school,junior high school,occupation for the freelance of women.4.The major object of women CIN prevention and control should be women aged from 30 to 50 in the city and from 35 to 50 in rural areas.5.electronic files conducive to information sharing,to ensure the integrity of information,comprehensive,timely.Improve the follow-up-rate,improve management quality.