焦虑情绪对胚胎移植妊娠结局的影响
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摘要
目的探讨接受体外受精-胚胎移植技术治疗的患者胚胎移植日焦虑情绪对妊娠结局的影响。方法采用随机抽样方法,将2016年10月至2017年10月在杭州市妇产科医院生殖医学中心进行体外受精-胚胎移植技术(IVF-ET)治疗的131名女性患者作为研究对象,胚胎移植日采用焦虑自评量表评估患者焦虑状况。根据焦虑程度对其进行分类,比较无焦虑、轻度焦虑、中度焦虑患者之间妊娠结局情况。结果 131名患者中有焦虑情绪者64人(48.9%);无焦虑组与焦虑组患者比较,其生化妊娠率、临床妊娠率和胚胎种植率差异均有统计学意义(均P<0.05);无焦虑组与轻度焦虑组患者比较,其生化妊娠率、临床妊娠率差异均有统计学意义(均P<0.05);无焦虑组与中度焦虑组患者比较,其临床妊娠率差异均有统计学意义(P<0.05)。结论患者在胚胎移植日普遍存在不同程度的焦虑情绪,轻度焦虑对近期妊娠结局即存在影响,医护人员必须在胚胎移植日加强患者心理干预,引导患者积极应对,改善不孕症患者妊娠结局。
Objective To explore the effect of anxiety on the embryo transferring(ET) day on the pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET) for infertile females. Methods A total of 131 infertile females undergoing IVF-ET in the Reproductive Medicine Center of Hangzhou Obstetrics and Gynecology Hospital from October 2016 to October 2017 were assessed by self-rating anxiety scale(SAS) on ET day. The pregnancy outcomes were compared between the three groups of no anxiety, mild anxiety and moderate anxiety. Results 64 females(48.9%) had anxiety. Among them, there were 55(42.0%) cases of mild anxiety, 9(6.9%) cases of moderate anxiety and 0 case of severe anxiety. The biochemical pregnancy rate, clinical pregnancy rate and implantation rate in anxiety group were lower than that in no anxiety group(all P<0.05). Mild anxiety group showed lower biochemical pregnancy rate and clinical pregnancy rate compared with no anxiety group(all P<0.05). Moderate anxiety group showed lower clinical pregnancy rate compared with no anxiety group(P<0.05). Conclusions There are different levels of anxiety on ET day among IVF-ET females and even mild anxiety may affect the near-term pregnancy outcomes. Therefore, psychological intervention should be strengthened on the ET day to improve the pregnancy outcomes.
Objective To explore the effect of anxiety on the embryo transferring(ET) day on the pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET) for infertile females. Methods A total of 131 infertile females undergoing IVF-ET in the Reproductive Medicine Center of Hangzhou Obstetrics and Gynecology Hospital from October 2016 to October 2017 were assessed by self-rating anxiety scale(SAS) on ET day. The pregnancy outcomes were compared between the three groups of no anxiety, mild anxiety and moderate anxiety. Results 64 females(48.9%) had anxiety. Among them, there were 55(42.0%) cases of mild anxiety, 9(6.9%) cases of moderate anxiety and 0 case of severe anxiety. The biochemical pregnancy rate, clinical pregnancy rate and implantation rate in anxiety group were lower than that in no anxiety group(all P<0.05). Mild anxiety group showed lower biochemical pregnancy rate and clinical pregnancy rate compared with no anxiety group(all P<0.05). Moderate anxiety group showed lower clinical pregnancy rate compared with no anxiety group(P<0.05). Conclusions There are different levels of anxiety on ET day among IVF-ET females and even mild anxiety may affect the near-term pregnancy outcomes. Therefore, psychological intervention should be strengthened on the ET day to improve the pregnancy outcomes.
引文
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[14] 蔡艳娜,董悦芝.不孕女性生活事件、压力反应、应对方式与生育压力的关系及应对方式的中介效应[J].中国全科医学,2017,20(6):715-719.
[15] 闵丽华,张潇潇,吕群.体外受精-胚胎移植患者不同阶段知识需求调查[J].护理学杂志,2009,24(6):14-15.
[16] 蒋玲,陈丹,张琼,等.阶段性健康教育联合肌肉松弛训练对体外受精-胚胎移植患者的影响[J].中华护理杂志,2017,52(2):166-170.
[17] Domínguez F,Garrido-Gómez T,López JA,et al.Proteomic analysis of the human receptive versus non-receptive endometrium using differential in-gel electrophoresis and MALDI-MS unveils stathmin 1 and annexin A2 as differentially regulated[J].Hum Reprod,2009,24(10):2607-2617.
[18] Bersinger NA,Wunder DM,Birkh?user MH,et al.Gene expression in cultured endometrium from women with different outcomes following IVF[J].Mol Hum Reprod,2008,14(8):475-484.
[2] 郭启云,颜丹,刘颖,等.体外受精胚胎移植患者焦虑、抑郁情绪与生育生命质量的相关性分析[J].中国实用护理杂志,2017,33(27):2081-2081.
[3] 张琼,陈丹,蒋玲,等.接受体外受精-胚胎移植治疗女患者个人社会心理因素对治疗结局的影响[J].护理学报,2016,23(20):1-4.
[4] 周晓景,谭丽.女性焦虑障碍对供精体外受精-胚胎移植妊娠结局的影响[J].中国继续医学教育,2016,8(18):71-72.
[5] 王向东,主编.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志社,1999:235-237.
[6] 李小红.体外受精-胚胎移植病人心理相关性研究[D].成都:四川大学,2007.
[7] 张琼,陈丹,蒋俐萍,等.行体外受精-胚胎移植女性患者焦虑抑郁现状及影响因素分析[J].护理学报,2017,24(14):43-47.
[8] 何玉洁,王瑛,土增荣,等.体外受精-胚胎移植过程中焦虑抑郁、子宫收缩频率和妊娠结局的相关性[J].山西医科大学学报,2016,47(12):1108-1111.
[9] Schweiger U,Wischmann T,Strowizki T.Mental disorders and female infertility[J].Der Nervenarzt,2012,83(11):1442-1447.
[10] 牟善芳,孙振高,陈莉军,等.心理干预对体外受精-胚胎移植患者心理状态及结局的影响[J].护理学杂志,2008,23(10):9-11.
[11] 唐惠艳,邱忠君,王成刚.以夫妻为中心的心理干预在体外受精-胚胎移植患者中的应用效果[J].中国实用护理杂志,2016,32(5):350-354.
[12] 吴汉霞,刘玉芹.健康教育在体外受精-胚胎移植患者取卵前后的应用[J].解放军护理杂志,2007,24(1):85-86.
[13] 苏霞,丛云凤.心理干预对体外受精-胚胎移植临床妊娠率影响的Meta分析[J].中国实用护理杂志,2013,29(1):66-68.
[14] 蔡艳娜,董悦芝.不孕女性生活事件、压力反应、应对方式与生育压力的关系及应对方式的中介效应[J].中国全科医学,2017,20(6):715-719.
[15] 闵丽华,张潇潇,吕群.体外受精-胚胎移植患者不同阶段知识需求调查[J].护理学杂志,2009,24(6):14-15.
[16] 蒋玲,陈丹,张琼,等.阶段性健康教育联合肌肉松弛训练对体外受精-胚胎移植患者的影响[J].中华护理杂志,2017,52(2):166-170.
[17] Domínguez F,Garrido-Gómez T,López JA,et al.Proteomic analysis of the human receptive versus non-receptive endometrium using differential in-gel electrophoresis and MALDI-MS unveils stathmin 1 and annexin A2 as differentially regulated[J].Hum Reprod,2009,24(10):2607-2617.
[18] Bersinger NA,Wunder DM,Birkh?user MH,et al.Gene expression in cultured endometrium from women with different outcomes following IVF[J].Mol Hum Reprod,2008,14(8):475-484.