摘要
目的 探索STD的病征处理流程图。方法 对1027例初诊病人临床表现（症状、体征）和实验检查结果进行统计分析,总结出8个病征和流程图。结果 临床表现为尿道分泌物按淋病和 NGU方案治疗使 92.94％的病人得到规范治疗;尿痛和尿道痒按NGU方案治疗,可使50％的病例获益;生殖器赘生物按尖锐湿疣方案治疗68.73％病人获益,醋酸白试验阴性者对症处理;生殖器溃疡按生殖器疱疹治疗,对60.27％的病人是恰当的;阴道分泌物多,按淋病和NGU方案治疗,只有43.13％病人是正确的;阴部瘙痒对症处理;阴囊肿痛 66.67％要对症处理;主动要求检查应进行健康咨询和必要检查。结论 8个病征图中,以尿道分泌物流程图的准确率最高,依次为生殖器赘生物、生殖器溃疡和阴道分泌物流程图,其余病征图需由经验丰富的医师来处理,方能避免过大的误诊和误治。阴道分泌物流程图若以淋病、NGU和厌氧菌感染方案（甲哨唑）治疗,准确率可达67.97％,甲哨唑的药价便宜,副反应小,利大于弊。
Objective: To explore a flow chart used for the treatment of STD cases. Methods: We made statistical analyses of the clinical manifestations (symptoms and physical sign) and the results of laboratory tests of 1 027 STD cases, presented to our institute for treatment for the first time. Eight syndromes and corresponding flow charts were summarized. Results: 92.44% patients with urethral discharges received gonorrhea and NGU's treatment regimes. 50% patients with dysuria and urethra itch benefited from a NGU treatment regime. 68.73% patients with eczema of external genitalia benefited from a treatment scheme of pointed condyloma. Those who got negative results from the acetic acid test were treated according to their symptoms. It was effective for 60. 27% patients with genital ulcer according to the treatment scheme of genital herpes. It was effective for only 43. 13% patients with profused vaginal discharge according to the treatment scheme of gonorrhea and NGU. Different treatments were given according to different symptoms in the patients with pruritus of external genitalium. Different treatments were given according to different symptom in 66.67% of patients with swelling and pain of scrotum. The patients who sought for medical examination should be provided with health consultation and necessary examinations. Conclusion: Among the 8 flow charts, the flow chart for those with urethra discharges had the highest effective treatment, followed by those with eczema of external genitalia, genital ulcer and vaginal discharge. Experienced doctors were needed for the other cases so as to avoid making wrong diagnosis and treatment. If vaginal discharge was treated according to the treatment scheme of gonorrhea - NGU - anaerobic bacteria infection ( metronidazal), the accurate ratio would be 67.97% . Cheap and with less side effects, metronidazal had more advantages than disadvantages.
出处
《中国性病艾滋病防治》
2001年第2期98-101,共4页
Chinese Journal of Std & Aids Prevention and Control
