發(fā)布時間：2019-04-22 19:26

【摘要】：背景及目的： 育齡女性是缺鐵的高發(fā)人群,月經(jīng)過多是致育齡女性缺鐵的重要原因。本研究以自行開發(fā)設計的月經(jīng)出血評分(MBS),測評女性月經(jīng)量,探討其對月經(jīng)過多女性缺鐵的預測作用。 對象及方法： 采用橫斷面觀察研究法.以2012年12月-2013年4月在北京海軍總醫(yī)院婦科門診就診的95例月經(jīng)過多女性為對象,以自行設計的月經(jīng)出血評分表(MBS)測評經(jīng)量,并完成血清鐵(SI)及血紅蛋白(Hb)等相關檢查,以探討MBS預測月經(jīng)過多女性缺鐵的臨床效用。 結果： 95例月經(jīng)過多女性中檢出缺鐵65例(68.42%),其中鐵耗減34例(35.79%)、缺鐵性紅細胞生成12例(12.63%)、缺鐵性貧血19例(20%)。Spearman分析及誤差限圖分析均表明,MBS評分與女性缺鐵程度顯著正相關(P0.01)。Logistic回歸示,MBS評分是影響月經(jīng)過多女性缺鐵的重要因素(P0.01)。ROC分析示,當女性MBS評分≥41.25時,提示有較高的缺鐵風險,有必要作進一步的實驗室缺鐵篩查,此時預測的靈敏度、特異度分別達50.77%、86.67%,ROC曲線下面積為0.705(P0.01)。 結論： MBS測評法操作簡易,能有效預測月經(jīng)過多女性的缺鐵風險,或在門診、社區(qū)基層、女性缺鐵普查及日常自我保健中有一定應用前景。 研究背景及目的： 月經(jīng)過多是育齡女性的常見病癥,可致女性缺鐵、貧血、疲勞,生理及心理健康狀況受損,生存質量下降。本研究以自行開發(fā)設計的月經(jīng)過多特異性生存質量評定表(MS-QOL),評估月經(jīng)過多女性的經(jīng)期生存質量,并探討量表的信效度及臨床使用價值。 對象和方法： 采用橫斷面觀察研究法。以2012年12月～2013年4月在北京海軍總醫(yī)院婦科門診就診的65例月經(jīng)過多女性為對象,同期參加健康體檢的22例月經(jīng)正常女性為對照,采集月經(jīng)史,以MS-QOL量表測評女性經(jīng)期生存質量,并完成血色素、血清鐵等相關檢查。 結果： (1) MS-QOL量表信效度分析：以探索性因子分析法提取出量表公因子2個,累積解釋變量達71.2%,量表與2個公因子的Cronbachα系數(shù)均0.7,量表各條目與其所屬因子的相關度均較高,且驗證性因子分析結果進一步證實,量表模型擬合效果較優(yōu),結構效度較好(x2值=106.94、P值=0.000、RMSEA=0.267、 IFI=0.829、TLI=0.673)。(2)MS-QOL量表臨床應用：與月經(jīng)正常組相比,月經(jīng)過多組女性的量表評分更高、經(jīng)期更長、衛(wèi)生巾用量更多、Hb及Hct更低；且spearman分析結果表明,量表評分與女性經(jīng)期長度及衛(wèi)生巾用量相關度較高,與Hb及Hct相關度較低,提示經(jīng)量增多可能是致月經(jīng)過多女性經(jīng)期生存質量降低的更重要原因。 結論： MS-QOL量表信效度較高,實用性較強,或可通過評估及動態(tài)監(jiān)測月經(jīng)過多女性經(jīng)期生存質量變化,指導個性化治療方案的制定,提高治療效果。 研究背景及目的： 月經(jīng)過多是育齡女性的常見病癥,臨床上多伴隨子宮肌瘤等婦科器質性病變發(fā)生,但約近半數(shù)的月經(jīng)過多女性無明顯婦科器質性病變,導致月經(jīng)過多的原因未明。近年有研究指,無婦科器質性病變的月經(jīng)過多女性中,有相當比例者止凝血功能低下,出血現(xiàn)象多見。MCMDM-1vWD量表是一種簡易、高效的出血傾向測評工具。但檢索相關文獻數(shù)據(jù)庫后(最后檢索時間2013-12-19-11：00),未發(fā)現(xiàn)有該量表的中文版本研制使用。本研究擬引入MCMDM-1vWD量表,翻譯成中文版本,評估月經(jīng)過多女性的出血傾向,并分析月經(jīng)過多女性出血傾向與止凝血功能狀態(tài)的相關關系。 對象和方法： 將MCMDM-1vWD量表譯成中文并回譯。以2012年12月～2013年4月在北京海軍總醫(yī)院婦科門診就診的39例無婦科器質性病變的月經(jīng)過多女性為研究對象,同期參加健康體檢的22例月經(jīng)正常女性為對照,采集月經(jīng)史,以MCMDM-1vWD量表評估出血傾向,并完成止凝血功能等相關檢查。 結果： 月經(jīng)過多女性中,有異常出血現(xiàn)象的人數(shù)占比、出血積分(BS)0分的人數(shù)占比,均高于月經(jīng)正常組。將月經(jīng)過多及月經(jīng)正常女性,進一步分成不同出血積分(BS)亞組后發(fā)現(xiàn),BS高分組(BS≥3)較BS低分組(BS≤0)經(jīng)期天數(shù)更長、衛(wèi)生巾用量更多,SI、MPV、Fib、vWF:Act、FVIII:C水平更低,PT更長。二分類logistic回歸發(fā)現(xiàn),月經(jīng)過多女性出血傾向增加(BS≥3)可能與PT延長有關。 結論： 無婦科器質性病變的月經(jīng)過多女性中,有相當比例者出血事件多見,出血傾向較明顯。以MCMDM-1vWD量表為工具進行出血傾向評估,可在一定程度上反映月經(jīng)過多女性的止凝血功能狀態(tài),具有一定臨床使用價值。
[Abstract]:Background and purpose: The female of the age of childbearing is a high-risk group of iron deficiency, and too much is an important source of iron deficiency in the female of childbearing age. The results of this study were based on the self-developed design of the menstrual bleeding score (MBS) and the amount of women's menstrual cycle, and the prediction of iron deficiency in excess of the women was discussed. to use. Object and methods: cross-section The study was carried out on the basis of a self-designed menstrual bleeding index (MBS), and the serum iron (SI) and hemoglobin (Hb) were completed. Peer-to-peer review to discuss MBS to predict the excess of iron deficiency in women Clinical Results:65 cases (68.42%) of iron deficiency were detected in 95 cases of excess iron,34 of iron (35.79%),12 (12.63%) of iron-deficiency red blood cells,19 (20%) of iron-deficiency anemia, and Spearman's analysis. The analysis of the error limit shows that the MBS score is positively correlated with the iron deficiency of the female (P0.01). Logistic regression shows that the MBS score is an important factor that affects the iron deficiency of the female (P0.01). The ROC analysis shows that, when the female MBS score is 41.25, it is suggested that there is a high risk of iron deficiency, and it is necessary to make an admission. The sensitivity and specificity of the step were 50.77%, 86.67% and 0.7 respectively under the ROC curve. 05 ( Conclusion: MBS evaluation method is easy to operate, can effectively predict the iron deficiency risk of excessive female, or in the clinic, community base, female iron deficiency general survey and day One of the most common self-care The background and purpose of the study are as follows: too many of the common diseases of the female of childbearing age, which can lead to the deficiency of iron, anemia, fatigue and birth of the female In order to assess the quality of life, the quality of life and the quality of life of the female in the menstrual period were assessed by the self-developed and self-developed mass index of the quality of life (MS-QOL). and explore the scale The validity of the letter and the value of clinical use . Object and method: The cross-sectional observation method was adopted. In the period from December 2012 to April 2013,65 cases of women with more than one female who were treated in the gynaecological clinic of the General Hospital of the Navy General Hospital of Beijing were the subject. In the same period,22 cases of healthy physical examination were taken as control, and the menstrual history was collected and the MS-Q was collected. The Evaluation of Women's Classics by OL Scale period of existence The results were as follows: (1) The reliability and validity of the MS-QOL scale:2, the cumulative interpretation variable was 71.2%, and the Cronbach index of the scale and the 2 male factors was calculated by the exploratory factor analysis method. The coefficient is 0.7, the correlation degree of each entry of the scale and its associated factor is high, and the results of the confirmatory factor analysis further confirm that the fitting effect of the scale model is superior, the structure validity is good (x2 value = 106.94, P value = 0.000, RMSEA = 0 (267, P = 0.829, TLI = 0.673). (2) The clinical application of the MS-QOL scale: Compared with the normal group of the menstrual cycle, the scale score of the female with too many groups is higher, the period is longer, the dosage of the sanitary towel is more, the Hb and Hct are lower, and the spearman analysis results It is shown that the correlation between the scale score and the length of the women's menstrual period and the dosage of the sanitary napkin is high, the correlation with the Hb and Hct is low, and the amount of the indication is increased. multiple possibilities Conclusion: The reliability and validity of MS-QOL scale are high, the practicability is strong, or the excessive female can be monitored by the evaluation and dynamic monitoring. quality of life in the period of menstrual period The development of the individualized treatment plan is guided, and the treatment effect is improved. The background and purpose of the study are as follows: hypermenorrhea is a common condition of the female of the childbearing age, and the clinic is accompanied by the occurrence of gynecological organic diseases such as the hysteromyoma, but About half of the women have no obvious gynaecological organic lesions, which have led to an excessive number of causes. In recent years, there have been researches on the non-gynaecological device In a large number of women with quality lesions, there is a significant proportion of women with low blood coagulation and bleeding. The MCMDM-1vWD scale is a simple and efficient tool for evaluating the bleeding tendency. However, after the relevant literature database is retrieved (the last retrieval time 2 013-12-19-11:00), no Chinese version of the scale was found to be used. The study is to introduce the MCMDM-1 vWD scale to be translated into Chinese version to assess the excess of women sex-based bleeding tendency And to analyze the tendency of excessive female bleeding and the function of stopping blood coagulation. The relationship between state and state. Object and method: The MCMDM-1vWD scale was translated into Chinese and translated into Chinese. In December,2012 to April,2013,39 women with no gynecological organic lesions were enrolled in the Gynecology Clinic of the General Hospital of the Navy General Hospital of Beijing. 2 cases of normal women were controlled and collected. history of menstruation To assess the bleeding tendency with the MCMDM-1 vWD scale and to complete the check of the blood-stopping function, etc. Results: too much In the female, the proportion of the number of patients with abnormal bleeding was higher than that of the normal group of the menstrual cycle, and the number of the bleeding points (BS)0 was higher than that of the normal group of the menstrual cycle. It was found that the number of the BS high-group (BS-3) was longer than that of the BS (BS-0), and the number of days in the BS-3 was longer than that of the BS-low group (BS-0). The amount of towel is more, SI, MPV, Fib, vWF: Act, FVIII: C is lower and PT is longer. class lo Logistic regression found that the increase in bleeding tendency in excess of women (BS%3) may be related to the extension of PT Conclusion: There is a significant proportion of bleeding events in women with no gynecological organic disease, and the bleeding tendency is more obvious.
【學位授予單位】：南方醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R711.51

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