門診婦女子宮頸抹面檢查結果異常之相關因素分析

Analysis of Correlative Factors Concerning Outpatient Women’s Abnormal Results of Pap Smear of Cervix

目的：瞭解門診婦女子宮頸抹片檢查結果異常之人口學特徵，探討其相關影響因素，以改善醫療服務及促進婦女健康。方法：以立意取樣法選擇某醫院門診接受子宮頸抹片檢查的438位婦女，以結構式問卷調查其人口學特徵及子宮頸癌風險因子之資料收集。結果：年齡較大、接受教育≦6年、懷孕次數愈多、生產次數較多、子宮頸癌家族史、吸菸、20歲以前有初次性經驗及性對象二人以上者較容易罹患低度或高度癌前細胞病變。多項邏輯斯迴歸分析發現：罹患低度癌前細胞病變者的年齡是無癌前細胞病變者的年齡的1.03倍（p=.056）；家族中有罹患子宮頸癌者罹患高度癌前細胞病變是家族中沒有罹患子宮頸癌者罹患相同病變的3.55倍（p=.069）；吸菸者罹患低度癌前細胞病變是無吸菸者罹患相同病變的2.77倍（p<.01）；≦20歲有初次性經驗者罹患低度癌前細胞病變是26歲以上有初次性經驗者罹患相同病變的2.05倍（p=.083）；性對象二人以上者分別罹患低度、高度癌前細胞病變是性對象一人者分別罹患低度、高度癌前細胞病變的3.61倍（p<.001）、4.96倍（p<.01）。結論：經調查可發現地區性子宮頸癌的高危險群及危害婦女健康的不良行為，藉個案管理定期追蹤，施以適當衛教與醫療諮詢，以增進社區婦女健康。

Objectives: The purpose of this study is to explore demographic characteristics and risk factors of the women with abnormal results of Pap smear of the cervix to improve healthcare service and facilitate women’s health. Methods: Using purposive sampling, we surveyed 438 women by structural questionnaire to collect data of demographic characteristics and risk factors of women who accepted Pap smear at OPD in one district hospital. Results: Those who were senior, had not more than 6 years of education, with high gravidity, high parity, family history of cervical cancer, smoking status, first sexual experience before the age of 20, and more than two sexual partners were near significantly susceptible to contract the low or high grade squamous intraepithelial lesion (LSIL or HSIL) of the cervix. Multinomial logistic regression analysis showed that the contracted age of the women with LSIL of the cervix was 1.03 times of the age of the women not contracted SIL (p=.056). Women with family history of cervical cancer contracted HSIL of the cervix were 3.55 times of those without family history of cervical cancer (p=.069). Women with smoking contracted LSIL of the cervix were 2.77 times of those without smoking (p<.01). Women with the first sexual experience before the age of 20 contracted LSIL of the cervix were 2.05 times of those after the age of 26 (p=.083). Women with more than two sexual partners contracted LSIL or HSIL of the cervix were respectively 3.61 and 4.96 times of those with only one sexual partner (p<.001, p<.01). Conclusions: Through the study, we find the high-risk group of cervical cancer and inadequate behaviors harmful to women’s health in one district. By providing case management, periodic follow-up, adequate health education and medical consultation, we can further facilitate women’s health in the community.