海南 广西小城镇诊所生殖道感染就诊者的感染危险因素以及临床意义  

Self-reported risks to STI of clients attending rural clinics in Guangxi and Hainan and their clinical significance.

作　　者：廖苏苏[1] 何启亚[2] 刘伟 廖锦芳 梁绍伶 裴东怒 李永振 王晓春 周月娇 

机构地区：[1]中国医学科学院基础医学研究所中国协和医科大学基础医学院流行病学教研室,北京100005 [2]海南省疾病预防控制中心流行病学研究所,海口570203 [3]广西壮族自治区艾滋病监测检测中心,南宁530021 [4]澄迈县卫生防疫站,海南澄迈县570000 [5]海南省皮肤性病研究所,海口570000 [6]广西壮族自治区皮肤性病研究所,南宁530000

出　　处：《中国艾滋病性病》2005年第2期116-120,共5页Chinese Journal of Aids & STD

基　　金：荷兰国际合作组织 (NOVIB)资助。

摘　　要：目的　描述3个有性服务产业的小城镇的公立、私立诊所生殖道感染就诊者自我报告的感染危险因素以及对临床服务的意义。方法　根据国家性病病征处理方案设计了门诊记录中有关危险因素的内容,1 999年和2 0 0 0年间,通过3个小城镇38家公立和私立诊所收集1 0 5 9位生殖道感染就诊者的门诊记录表。结果　1 0 5 9位就诊者中,男性患者4 94例(47%) ,平均年龄34岁;女性就诊者5 6 5例,平均年龄2 5岁。公立和私立诊所就诊者的性病病征处理诊断类型分布相近,其中分泌物病征的比例占2 / 3以上。>70 %的患者报告就诊前最近的一次性交中没有使用过安全套。对“性伴是否有疑似性病症状”的问题,医生没有询问或者得不到肯定回答的比例高达70 %～90 %。部分就诊者(1 999年约1 8%,2 0 0 0年约2 6 %)在个人性关系方面没有报告明确的“感染危险”。结论　目前在这些小城镇诊所服务中,使用国家推荐的危险因素评分改善病征处理临床决策作用有限。Objective To describe STI-related risks self reported by clients with STIs symptoms seeking medical care in private and public clinics of three rural towns in Guangxi and Hainan provinces.Methods Based on risk assessment in the national protocol of syndromic approach to STI management,we developed 6 questions related to STIs risks in the cosultion form for clients with STI symptoms. One thousand and fifty nine forms were filled by the clients of 38 public and private clinics at three towns in 1999 and 2000.Results Of 1 059 clients,there were 494 men(47%)with a mean age of 34 years,in comparing with the mean age of 25 years for the 565 cases women.The proportions of various syndromic diagnoses in public clinics resembled that of the diagnoses in private clinics.More than two thirds of the clients were diagnosed as discharge syndromes.Above 70% of the clients reported not using a condom in the last sex.About 70%-90% of the responses to the question on sexual partners'suspect symptoms were either uncertain or missing.A portion of the clients(18% in 1999;26% in 2000)did not report any self-perceived risks in their sexual relationship.Conclustion Using the recommended protocol of risk assessment in these rural clinics appeared to have limited significance in differentiating clients at higher risk from those at low rsk so as to improve management.

关 键 词：性病就诊者 自我报告危险行为 危险评估 性病病征处理 

分 类 号：R759[医药卫生—皮肤病学与性病学]