本文選題：鐵路女職工 + 健康狀況�。� 參考：《山東大學(xué)》2012年碩士論文

【摘要】：研究背景 隨著社會(huì)經(jīng)濟(jì)的飛速發(fā)展,職業(yè)女性越來(lái)越成為一個(gè)龐大的群體,她們?cè)谏鐣?huì)經(jīng)濟(jì)發(fā)展中起著至關(guān)重要的作用,她們的地位有了極大提高,其健康狀況也越來(lái)越受到社會(huì)和其自身的關(guān)注。由于鐵路企業(yè)的特殊性,工作環(huán)境條件(連續(xù)作業(yè),正常生物節(jié)律被打斷等)的限制,導(dǎo)致了鐵路女職工一些疾病的高發(fā)。通過(guò)一系列的文獻(xiàn)檢索,發(fā)現(xiàn)目前針對(duì)鐵路女職工查體結(jié)果的分析報(bào)告不少,但大多只是對(duì)女職工的生殖健康狀況作出評(píng)價(jià)、分析其中可能的危險(xiǎn)因素,并針對(duì)這些危險(xiǎn)因素提出一些簡(jiǎn)單的建議,尚缺乏對(duì)查體資料的全面分析,如女職工慢性非傳染疾病發(fā)生情況、女職工婦科疾病與各種危險(xiǎn)因素之間的關(guān)聯(lián)強(qiáng)度、同一危險(xiǎn)因素對(duì)不同疾病的致病作用大小等。濟(jì)南鐵路局現(xiàn)有女職工3萬(wàn)多人,僅濟(jì)南地區(qū)就有6000多人,她們大多工作在列車、車站等一些單位,因此,對(duì)濟(jì)南地區(qū)鐵路系統(tǒng)這一特殊行業(yè)的女職工健康狀況進(jìn)行調(diào)查,分析危險(xiǎn)因素與主要疾病之間的相關(guān)性并提出相應(yīng)的建議是很有必要的。 目的 通過(guò)對(duì)濟(jì)南地區(qū)鐵路女職工的健康狀況調(diào)查與分析,了解該系統(tǒng)女職工健康狀況的分布以及與疾病發(fā)病風(fēng)險(xiǎn)相關(guān)聯(lián)的危險(xiǎn)因素；并根據(jù)研究結(jié)果提出相關(guān)建議,為制定疾病早期預(yù)防措施、提高女職工健康水平提供依據(jù)。 方法 本研究采用現(xiàn)況研究中普查的研究方法,以濟(jì)南地區(qū)鐵路系統(tǒng)為研究現(xiàn)場(chǎng),以在職已婚女職工為研究對(duì)象,對(duì)研究對(duì)象進(jìn)行健康查體,收集相關(guān)數(shù)據(jù)信息。所獲數(shù)據(jù)資料經(jīng)核對(duì)無(wú)誤后,輸入計(jì)算機(jī),建立Excel數(shù)據(jù)庫(kù),采用SPSS17.0軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)處理,統(tǒng)計(jì)方法包括：統(tǒng)計(jì)描述,計(jì)數(shù)資料比較采用卡方檢驗(yàn),采用非條件Logistic回歸分析進(jìn)行研究對(duì)象主要婦科疾病的單因素和多因素分析。設(shè)α=0.05。 結(jié)果 1.本次現(xiàn)況研究以已婚在職女職工作為研究對(duì)象,符合研究對(duì)象條件的共有6848人,實(shí)際有6164人提供了研究數(shù)據(jù),無(wú)應(yīng)答684人,應(yīng)答率為90.01%,除去資料不完整的20人,用于資料分析的6144人,平均年齡40.23±8.18(20-56)歲。 2.本次普查檢出的主要疾病(患病率)有：子宮肌瘤(20.82%)、乳腺增生(16.36%)、宮頸炎(15.93%)、脂肪肝(13.44%)、高脂血癥(10.95%)、高血壓(8.19%)、膽囊疾病(6.48%)、高血糖(3.52%)、心律失常(3.09%)和冠心病(0.18%)等。患病率居前三位的疾病為子宮肌瘤、乳腺增生和宮頸炎。 3.研究對(duì)象婦科疾病的總患病率隨著年齡的增長(zhǎng)不斷增加,在46～50歲年齡段達(dá)到高峰,為64.17%。子宮肌瘤患病率隨著年齡的增加而逐漸增加,46-50歲年齡段患病率最高,為31.69%；乳腺增生患病率,31～45歲年齡段維持在較高水平,46歲以后逐漸降低；宮頸炎的患病率,25歲以下較低,患病率為1.63%,26歲以后逐漸增高,31～40歲年齡段維持在較高水平,以后隨年齡逐漸降低。 4.研究對(duì)象幾種慢性病(脂肪肝、高脂血癥、高血壓等)的患病率呈現(xiàn)出隨著年齡增長(zhǎng)而上升的趨勢(shì),年齡與疾病之間呈正相關(guān)(P0.01),在45～56歲年齡組時(shí)的患病率最高,然而某些慢性病(如脂肪肝、高脂血癥等)在年輕組中就占有一定比例。 5.主要婦科疾病相關(guān)因素分析結(jié)果：①與子宮肌瘤發(fā)病風(fēng)險(xiǎn)相關(guān)聯(lián)的危險(xiǎn)因素有年齡、高舒張壓(OR=1.608,95%CI：1.142-2.265)、血小板計(jì)數(shù)增加(OR=1.347,95%CI：1.118-1.622)和低血紅蛋白(OR=1.821,95%CI：1.425-2.326),年齡段在36～40歲時(shí),子宮肌瘤的發(fā)病風(fēng)險(xiǎn)是35歲及以下年齡組的4.233倍(OR=4.233,5%CI：3.118-5.747),年齡段在41～56歲時(shí)子宮肌瘤的發(fā)病風(fēng)險(xiǎn)是35歲及以下年齡組的10.008倍(OR=10.008,95%CI：7.692-13.021)。 ②與乳腺增生發(fā)病風(fēng)險(xiǎn)相關(guān)聯(lián)的危險(xiǎn)因素有年齡、工種(OR=1.590,95%CI：1.317-1.920)、低血糖(OR=1.600,95%CI：1.272-2.012)和低甘油三酯(OR=I.500,95%CI：1.204-1.867),年齡段在31-45歲時(shí)乳腺增生的發(fā)病風(fēng)險(xiǎn)分別是30歲及以下年齡段的3.778倍(OR=3.778,95%CI：2.901-4.919),當(dāng)年齡段增加至46-56歲時(shí)乳腺增生的發(fā)病風(fēng)險(xiǎn)是30歲及以下年齡段的2.473倍(OR=2.473,95%CI：1.855-3.298) ③與宮頸炎發(fā)病風(fēng)險(xiǎn)相關(guān)聯(lián)的因素有年齡、工種(OR=1.210,95%CI：1.019-1.437)、高膽固醇(OR=0.439,95%CI：0.268-0.719)和低甘油三酯(OR=1.306,95%CI：1.041-1.637),年齡段在31-45歲時(shí)宮頸炎的發(fā)病風(fēng)險(xiǎn)是30歲及以下年齡段的2.281倍(OR=2.281,95%CI：1.810-2.874),當(dāng)年齡段增加至46-56歲時(shí)宮頸炎的發(fā)病風(fēng)險(xiǎn)是30歲及以下年齡段的1.460倍(OR=1.460,95%CI：1.126-1.892)。 結(jié)論 1.濟(jì)南地區(qū)鐵路系統(tǒng)女職工患病率居前三位的疾病是子宮肌瘤、乳腺增生和宮頸炎,患病率分別為20.82%、16.36%和15.93%。 2.子宮肌瘤、乳腺增生和宮頸炎等主要婦科疾病均與年齡有關(guān),患病率呈現(xiàn)出隨著年齡增長(zhǎng)而上升的趨勢(shì),年齡段在36-40歲時(shí),子宮肌瘤的發(fā)病風(fēng)險(xiǎn)是35歲及以下年齡組的4.233倍,年齡段在41-56歲時(shí)子宮肌瘤的發(fā)病風(fēng)險(xiǎn)是35歲及以下年齡組的10.008倍；年齡段在31-45歲時(shí)乳腺增生和宮頸炎的發(fā)病風(fēng)險(xiǎn)分別是30歲及以下年齡段的3.778倍和2.281倍,當(dāng)年齡段增加至46-56歲時(shí)乳腺增生和宮頸炎的發(fā)病風(fēng)險(xiǎn)分別是30歲及以下年齡段的2.473倍和1.460倍,提示年齡是研究對(duì)象主要婦科疾病的共同的且獨(dú)立的危險(xiǎn)因素。 3.高舒張壓是子宮肌瘤發(fā)病的獨(dú)立危險(xiǎn)因素,血小板計(jì)數(shù)增加、血紅蛋白低也與子宮肌瘤相關(guān),可能是子宮肌瘤發(fā)病后導(dǎo)致的結(jié)果；血糖、血脂異常與乳腺增生、宮頸炎的發(fā)生相關(guān)聯(lián),具體機(jī)制有待于進(jìn)一步研究和分析。
[Abstract]:Research background
With the rapid development of social economy, professional women have become a huge group. They play a vital role in the social and economic development, their status has been greatly improved, and their health is becoming more and more concerned with the society and their own attention. The restriction of normal biological rhythm has resulted in the high incidence of some diseases of the railway female workers. Through a series of literature searches, we found that there are many analysis reports on the results of the examination of the railway female workers, but most of them only evaluate the reproductive health of women workers, analyze the possible risk factors, and aim at these dangers. The risk factors put forward some simple suggestions, but there is still a lack of comprehensive analysis of the physical examination data, such as the occurrence of chronic non infectious diseases of women workers, the intensity of the association between women's gynecologic diseases and various risk factors, the size of the same risk factors for different diseases. More than 30 thousand women workers in Ji'nan Railway Bureau, only the Ji'nan land. There are more than 6000 people in the district. Most of them work in trains, stations and other units. Therefore, it is necessary to investigate the health status of women workers in the special industry of the Ji'nan railway system, to analyze the correlation between the risk factors and the main diseases and to put forward the corresponding suggestions.
objective
Through the investigation and analysis of the health status of the female railway workers in Ji'nan, the distribution of the health status of the female workers and the risk factors associated with the risk of disease were understood, and the relevant suggestions were put forward according to the results of the study, which provided the basis for the formulation of early prevention measures for the disease and the improvement of the health level of female workers.
Method
This research adopts the research method of the survey in the current situation study, taking the Ji'nan railway system as the research site, taking the married female workers as the research object, carrying on the health examination to the research object and collecting the relevant data information. After the data are checked and checked, the Excel database is set up and the SPSS17.0 software is used to the data. Statistical methods include statistical description, statistical description, comparison of counting data with chi square test, single factor and multi factor analysis of major gynecologic diseases by non conditional Logistic regression analysis.
Result
1. the present study was based on the research object of married working women workers. There were 6848 people in accordance with the conditions of the study. In fact, 6164 people provided research data, no response to 684 people, response rate of 90.01%, 20 incomplete data, 6144 of data analysis, average age 40.23 + 8.18 (20-56) years old.
2. the main diseases detected in this survey were uterine myoma (20.82%), hyperplasia of mammary gland (16.36%), cervicitis (15.93%), fatty liver (13.44%), hyperlipidemia (10.95%), hypertension (8.19%), gallbladder disease (6.48%), hyperglycemia (3.52%), arrhythmia (3.09%) and coronary heart disease (0.18%). The disease rate in the top 2. was uterine myoma, mammary gland tumor, mammary gland, breast, breast, breast, and breast Hyperplasia and cervicitis.
3. the total prevalence rate of gynecologic diseases increased with age and reached the peak at the age of 46~50 years. The prevalence rate of 64.17%. uterine myoma increased with age, the highest rate of age 46-50 years old, 31.69%. The incidence of hyperplasia of mammary glands, the age of 31~45 years, after 46 years of age. Gradually decreasing, the incidence of cervicitis, lower than 25 years old, the prevalence rate of 1.63%, gradually increased after 26 years of age, 31~40 years of age to maintain a higher level, and then gradually decrease with age.
4. the prevalence of several chronic diseases (fatty liver, hyperlipidemia, hypertension, etc.) showed a tendency to increase with age. Age was positively correlated with disease (P0.01), and the prevalence rate was highest at the age of 45~56. However, some chronic diseases (such as fatty liver, hyperlipidemia, etc.) were in a certain proportion in the young group.
5. analysis of major gynecologic disease related factors: (1) the risk factors associated with the risk of uterine myoma are age, high diastolic pressure (OR=1.608,95%CI:1.142-2.265), increased platelet count (OR=1.347,95%CI:1.118-1.622) and low hemoglobin (OR=1.821,95%CI: 1.425-2.326), and the onset of uterine myoma at the age of 36~40. The risk of disease was 4.233 times (OR=4.233,5%CI:3.118-5.747) in the age group of 35 years and below, and the risk of uterine myoma at age 41~56 was 10.008 times (OR=10.008,95%CI:7.692-13.021) in the age group of 35 years and below.
The risk factors associated with the risk of mammary hyperplasia were age, OR=1.590,95%CI:1.317-1.920, hypoglycemia (OR=1.600,95%CI:1.272-2.012) and low triglyceride (OR=I.500,95%CI:1.204-1.867), and the risk of hyperplasia of mammary glands at age 31-45 was 3.778 times as high as that of 30 years and below (OR=3.778,95%CI 2.901-4.919), when the age increased to 46-56 years, the risk of breast hyperplasia was 2.473 times that of the age group 30 and below (OR=2.473,95%CI:1.855-3.298).
(3) the factors associated with the risk of cervicitis were age, OR=1.210,95%CI:1.019-1.437, high cholesterol (OR=0.439,95%CI:0.268-0.719) and low triglyceride (OR=1.306,95%CI:1.041-1.637). The risk of cervicitis at age 31-45 was 2.281 times (OR=2.281,95%CI:1.810-2.874) at the age of 30 and below. The risk of cervicitis is 1.460 times higher than that of age 30 and below when age reaches 46-56 years old (OR=1.460,95%CI:1.126-1.892).
conclusion
1. the prevalence rate of female workers in railway system in Ji'nan is the highest in the top three, which are uterine fibroids, hyperplasia of mammary glands and cervicitis. The prevalence rates are 20.82%, 16.36% and 15.93%. respectively.
2. the main gynecologic diseases such as myoma of uterus, hyperplasia of mammary glands and cervicitis are related to age, and the incidence of the disease tends to rise with age. At the age of 36-40, the risk of uterine myoma is 4.233 times that of the age group of 35 years and below, and the risk of uterine myoma at the age of 41-56 is the age group of 35 years and below. At the age of 31-45, the risk of hyperplasia of mammary glands and cervicitis was 3.778 times and 2.281 times of age 30 and below, and the risk of hyperplasia of mammary glands and cervicitis at the age of 46-56 was 2.473 and 1.460 times as much as 30 years and below, suggesting that age is the main gynecologic subject of the study. A common and independent risk factor for disease.
3. high diastolic pressure is an independent risk factor for the onset of myoma of uterus. The platelet count increases and the low hemoglobin is associated with uterine myoma. It may be the result of uterine myoma. Blood glucose, dyslipidemia is associated with the occurrence of hyperplasia of mammary glands and cervicitis, and the specific mechanism needs further study and analysis.

【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R173

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9 杜靜;朱佩英;;自凝刀射頻介入治療子宮肌瘤鉗夾術(shù)484例療效分析[A];中國(guó)儀器儀表學(xué)會(huì)醫(yī)療儀器分會(huì)2010兩岸四地生物醫(yī)學(xué)工程學(xué)術(shù)年會(huì)論文集[C];2010年

10 孫大為;郎景和;劉珠鳳;冷金花;朱蘭;黃榮麗;;腹腔鏡下多發(fā)子宮肌瘤剔除術(shù)的臨床探討[A];第八次全國(guó)婦產(chǎn)科學(xué)學(xué)術(shù)會(huì)議論文匯編[C];2004年

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8 翁淑賢;子宮肌瘤未必都得切[N];威海日?qǐng)?bào);2008年

9 記者 王鵬飛;市第五人民醫(yī)院婦產(chǎn)科成功實(shí)施我市首例經(jīng)陰式剔除多發(fā)性子宮肌瘤手術(shù)[N];焦作日?qǐng)?bào);2009年

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