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子宫颈癌综合防控指南(第2版)
$38.98
1.人民卫生出版社优秀之作。首版出版于2017年,累计印次7次,印数1.7万册,广受读者好评。2.在国家卫生健康委员会妇幼健康司支持下,由中华预防医学会妇女保健分会联合妇幼健康研究会宫颈癌防控研究专业委员会为指导和规范我国子宫颈癌防控工作和项目而组织专家编写。3.集预防保健与临床服务、专业技术与业务管理为一体的实用工具书,不仅对子宫颈癌防治专业技术人员解决实际工作中的问题具有指导意义,同时对各级项目管理人员、从事疫苗预防接种和健康教育的公共卫生专业人员在开展子宫颈癌防治工作中也有较强的指导作用。
1.新版在原指南基础上,根据国际国内新发布的子宫颈癌相关指南、立场文件、专家共识、HPV疫苗及子宫颈癌筛查、治疗、管理的循证医学研究和实践新进展进行了内容更新。2.从临床医学、公共卫生和卫生管理三个方面进行全面阐述,包括子宫颈癌综合防控与管理、以人群为基础的子宫颈癌防控管理与实施、健康教育、预防性HPV疫苗接种、子宫颈癌筛查方法和流程、子宫颈癌前病变的诊断和处理,以及浸润性子宫颈癌的处理原则等。3.内容系统,工作流程清晰,服务步骤具体,具有较强的针对性、实用性和实践指导性。
主要从事妇女保健、生殖健康领域的研究、项目、培训与教学工作。近年来作为科研和项目负责人开展在我国贫困地区降低孕产妇、婴儿死亡率、提高孕产期保健综合服务、探讨科学的管理模式、有效提高服务质量和服务利用的研究和干预项目;承担多项与妇女生殖健康与保健相关的研究与项目;作为课题负责人申请国家"十五"攻关课题"我国艾滋病母婴传播模式及综合预防策略的研究"。
章 背景/1 节 子宫颈癌的流行病学状况 / 1第二节 子宫颈癌的病因和疾病自然史 / 3第二章 子宫颈癌综合防控与管理/ 10 节 子宫颈癌综合防控策略 / 10第二节 子宫颈癌综合防控策略的实施 / 13第三章 健康教育与咨询/25 节 健康教育 / 25第二节 咨询 / 30第四章 HPV 疫苗接种/35 节 HPV 疫苗的作用机制 / 35第二节 预防性HPV 疫苗的效果和安全性 / 37第三节 HPV 疫苗的免疫策略 / 42第四节 HPV 疫苗接种服务 / 49第五章 子宫颈癌筛查 54 节 子宫颈癌筛查方法 / 54第二节 子宫颈癌筛查方案和管理 / 58第六章 子宫颈癌前病变的诊断及治疗/ 68 节 子宫颈癌前病变的诊断方法 / 68第二节 子宫颈活检组织病理学诊断标准 / 71第三节 组织病理学确诊的子宫颈上皮内病变的管理原则 / 72第四节 组织病理学确诊的子宫颈癌前病变的治疗与随访 / 75第七章 子宫颈浸润癌的诊断和治疗/81 节 子宫颈浸润癌的诊断 / 81第二节 子宫颈浸润癌的临床分期 / 84第三节 子宫颈浸润癌的治疗 / 85附录/91 附录1 名词解释 / 91附录2 子宫颈癌综合防控与管理相关表格 / 92附录3 子宫颈癌筛查标本取材方法 / 100附录4 子宫颈细胞学贝塞斯达报告系统(TBS-2014) / 101附录5 阴道镜检查步骤和注意事项 / 105附录6 子宫颈癌前病变常用治疗方法 / 108缩略语英中文对照/113
子宫颈癌是严重威胁妇女生命的恶性肿瘤之一。据世界卫生组织/ 国际癌症研究署(World Health Organization/International Agency for Research onCancer,WHO/IARC)2020 年统计数据显示,子宫颈癌为女性第四大恶性肿瘤,全球新发子宫颈癌病例60.4 万,死亡34.2 万,其中88.1% 的新发病例和91.4%的死亡病例发生在中、低收入国家。2020 年中国肿瘤登记年报报告,2016 年子宫颈癌新发病例数达到11.93 万,死亡病例数达到3.72 万。虽然经过几十年的综合防控,我国初步建立了妇女常见病防控体系,防治技术不断提高,但子宫颈癌防控仍然面临严重挑战。近20 年来,我国子宫颈癌发病率和死亡率呈上升趋势,全国东、中、西部地区及城市和农村发病率、死亡率均存在明显差异。子宫颈癌防治作为一个公共卫生问题已引起我国政府的高度重视和关注,自2009年起,国家卫生部(现国家卫生健康委员会)和中华全国妇女联合会启动了“农村妇女子宫颈癌检查项目”,并于2019 年将子宫颈癌筛查纳入“基本卫生公共服务项目”,在妇女保健常规工作中积极推进,对于进一步扩大子宫颈癌人群筛查覆盖面起到了积极的促进作用。目前我国子宫颈癌筛查工作仍然面临经费支持不足,适龄妇女子宫颈癌筛查覆盖人数有限;基层相关专业技术人员缺乏或技能不足以及监督指导体系和信息系统不完善;妇女对子宫颈癌防治知识缺乏,主动筛查意识较低等诸多问题。为了指导和规范我国子宫颈癌防控工作和项目开展,亟需开发国家层面的子宫颈癌综合防控指南。2017 年在国家卫生和计划生育委员会妇幼健康司指导下,中华预防医学会妇女保健分会组织我国在妇女保健、妇科肿瘤、子宫颈细胞学、病理学、公共卫生领域的知名专家学者和卫生行政管理人员共同编写了《子宫颈癌综合防控指南》。该书自出版以来,已经在全国各级各类医疗保健机构开展子宫颈癌防治工作中得到了广泛应用,至今已历时近6 年。随着世界卫生组织2020 年发布《加速消除子宫颈癌的全球战略(2023—2030 年)》和国务院颁发《中国妇女发展纲要(2021—2030 年)》的新要求,以及我国子宫颈癌综合防控体系建设日趋完善,全球HPV 疫苗使用更新及我国HPV 国产疫苗的研发和上市,我国子宫颈癌防控相关的指南和专家共识陆续发布,子宫颈癌防治相关内容需要进一步更新。为此,在国家卫生健康委员会妇幼健康司支持下,中华预防医学会妇女保健分会再次组织国内专家更新和撰写了《子宫颈癌综合防控指南》(第2 版),在原指南基础上,根据国际国内新发布的子宫颈癌相关指南、立场文件、专家共识、HPV 疫苗及子宫颈癌筛查、治疗、管理的循证医学研究和实践新进展,对本指南进行了内容更新。本书内容涵盖了子宫颈癌一、二、三级预防,包括子宫颈癌综合防控意义和策略、以人群为基础的子宫颈癌防控管理与实施、健康教育、预防性HPV 疫苗接种、子宫颈癌筛查方法和流程、子宫颈癌前病变的诊断和处理以及子宫颈浸润癌的处理原则等重点内容,从临床医学、公共卫生和卫生管理三个方面进行了全面阐述。同时,每一章节后附有参考文献,便于读者延伸阅读;另外,本书还附有便于操作和理解的图和表。本书集预防保健与临床服务、专业技术与业务管理为一体的实用工具书,工作流程清晰,服务步骤具体,具有较强的针对性、实用性和实践指导性,不仅对子宫颈癌防治专业技术人员解决实际工作中的问题具有指导意义,同时对各级项目管理人员、从事疫苗预防接种和健康教育的公共卫生专业人员在开展子宫颈癌防治工作中也有较强的指导作用。本书由中华预防医学会妇女保健分会联合中国妇幼健康研究会宫颈癌防控研究专业委员会组织专家编写,参与该书编写的人员均为在妇女保健、妇科肿瘤、病理学、预防医学与卫生管理等方面有着丰富经验的专家学者,在此,向所有参加编写的专家及相关人员的辛勤付出和支持表示衷心的感谢。由于我们在专业理论和技术规范方面的认识和经验有限,本书出版之际,希望广大读者在阅读过程中不吝赐教,欢迎发送邮件至邮箱renweifuer@pmph.com,或扫描封底二维码,关注“人卫妇产科学”,对我们的工作予以批评指正,以期再版修订时进一步完善,更好地提高本书的质量。主 编2023 年6 月
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