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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 self-reported risk factors for infection and their implications for clinical services among patients with reproductive tract infections in public clinics and private clinics in three towns with sex service industries. Methods According to the treatment plan of STDs, the contents of outpatient records related to risk factors were designed. From 1999 to 2000, 1055 people with reproductive tract infections were collected through 38 public and private clinics in three small towns Outpatient records. Results A total of 1045 male patients (47%) were enrolled, with an average age of 34 years and 565 female patients, with a mean age of 25 years. The distribution of diagnosis types of STDs in public and private clinics are similar, with the proportion of the secretions accounting for more than 2/3. > 70% of patients reported no condom use in the most recent sexual intercourse before their visit. On the “sexual partner if there is suspected symptoms of STD” problem, the doctor did not ask or do not get a positive answer as high as 70% to 90%. Some patients (about 18% in 1999 and about 26% in 2000) did not report a clear “risk of infection” in their personal sexual relations. Conclusion At present, the use of nationally recommended risk factor scores to improve the clinical decision-making in symptom management in these small town clinics is limited.