Cognitive behavior therapy,Intrauterine insemination,Sex hormone,Psychology,Pregnancy
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,"/> <span style="font-size:14px;line-height:2;">认知行为疗法对宫腔内夫精人工授精</span><span style="font-size:14px;line-height:2;">患者临床妊娠结局及心理状态的影响</span>
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发育医学电子杂志  2022, Vol. 10 Issue (1): 25-30    DOI: 10.3969/j.issn.2095-5340.2022.01.005
  围产医学   论著 |产科 |
认知行为疗法对宫腔内夫精人工授精患者临床妊娠结局及心理状态的影响
连水燕 任建枝
( 陆军第七十三集团军医院 生殖医学中心, 福建 厦门 361000)
Effect of cognitive behavioral therapy on the clinical pregnancy outcome and mental state of patients with intrauterine insemination
Lian Shuiyan, Ren Jianzhi
(Reproductive Medicine Center, Military Hospital of the 73rd Army Group, Fujian, Xiamen 361000, China)
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摘要 【摘要】 目的 探讨认知行为疗法对宫腔内夫精人工授精(intrauterine insemination,IUI)患者临床妊娠结局及心理状态的影响。 方法 选取2017 年10 月至2019 年6 月在陆军第七十三集团军医院生殖医学中心接受IUI 治疗的156 例患者为研究对象。按照随机数字表法分为观察组与对照组,每组各78 例。两患者均采用标准化常规护理措施,观察组在此基础上行认知行为疗法。所有患者在入院时及第1 周期结束时填写90 项症状自评量表(symptom checklist 90, SCL-90)。比较两组患者心理状态、临床妊娠率及各周期放弃治疗比例。采用χ2 检验、Fisher 确切概率法、t 检验进行统计分析。 结果 两组患者在年龄、不孕年限、文化程度、不孕构成、促排卵方案及不孕原因等基线资料间比较,差异无统计学意义(P>0.05)。156 例患者共402 个IUI 周期,其中临床妊娠34 例,临床妊娠率为21.8%,周期妊娠率为8.5%。观察组与对照组的临床妊娠率分别为25.6%(20/78)与18.0%(14/78),但差异无统计学意义(χ2=1.354,P=0.245)。每个周期中,对照组与观察组的临床妊娠率比较,差异也无统计学意义(P 值均>0.05)。第2 周期,对照组放弃率为7.1%(5/70),观察组无放弃病例(P=0.028);第3 周期,对照组的放弃率高于观察[21.3%(13/61)与3.1%(2/64),χ2=8.136,P=0.004]。在IUI 第1 周期结束时,对照组中除强迫因子外其余9 个因子评分均低于入院时;观察组10 个因子评分均低于入院时。入院时两组患者的SCL-90 自评评分比较,差异无统计学意义(P 值均>0.05)。在IUI 第1 周期结束时,对照组与观察组患者躯体化(2.1±1.0 与1.7±0.7)、强迫(1.9±0.9 与1.6±0.8)、人际关系(2.4±0.9 与1.9±0.9)、抑郁(2.6±1.0 与2.2±1.1)、焦虑(2.2±1.0 与1.7±0.8)、敌对(2.0±1.0 与1.7±0.8)6 个因子评分比较,观察组均明显低于对照组(P 值均<0.05)。 结论 认知行为疗法可有效促进护患沟通,改善IUI 患者不良心理状态,减少放弃治疗例数,可尝试在临床推广。
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关键词:  认知行为疗法  宫腔内夫精人工授精  性激素  心理  妊娠率    
Abstract: 【Abstract】 Objective To explore the effect of cognitive behavioral therapy on clinical pregnancy
outcome and psychological state of patients with intrauterine insemination (IUI). Methods 156 patients who received IUI treatment in the Reproductive Medicine Center of Military Hospital of the 73rd Army Group from October 2017 to June 2019 were selected as the research objects. According to the random number table, they were divided into observation group and control group, with 78 cases in each group. Both groups were treated with standardized routine nursing measures, and the observation group was treated with cognitivebehavioral therapy in additoon. All patients filled in the symptom checklist 90 (SCL-90) at admission and at the end of the first cycle. The psychological status, clinical pregnancy rate and the proportion of giving up treatment in each cycle were compared between the two groups. Chi-square, Fisher exact probability method and t-test were used for statistical analysis. Results There was no significant difference between the two groups in age, infertility years, education level, infertility composition, ovulation induction scheme or infertility causes (P>0.05). There were 402 IUI cycles in 156 patients, including 34 clinical pregnancies. The clinical pregnancy rate was 21.8% and the cycle pregnancy rate was 8.5%. The clinical pregnancy rates of the observation group and the control group were 25.6% (20/78) and 18.0% (14/78), respectively, but there was no significant difference (χ2=1.354, P=0.245). In each cycle, there was no significant difference in the clinical pregnancy rate between the control group and the observation group (P>0.05). In the second cycle, the abandonment rate of the control group was 7.1% (5/70), and there were no abandonment cases in the observation group (P=0.028). In the third cycle, the abandonment rate of the control group was higher than that of the observation group [21.3% (13/61) vs 3.1% (2/64), χ2=8.136, P=0.004]. At the end of the first cycle of IUI, the SCL-90 scores of the 9 factors in the control group were lower than those at admission, while the scores of 10 factors in the observation group were lower than those at admission. There was no significant
difference in SCL-90 self-assessment scores between the two groups at admission (P>0.05). At the end of
the first cycle of IUI, the scores of somatization (2.1±1.0 vs 1.7±0.7), compulsion (1.9±0.9 vs 1.6±0.8),
interpersonal relationship (2.4±0.9 vs 1.9±0.9), depression (2.6±1.0 vs 2.2±1.1), anxiety (2.2±1.0 vs
1.7±0.8) and hostility (2.0±1.0 vs 1.7±0.8) in the control group were significantly higher than those
in the observation group (P<0.05). Conclusion Cognitive behavioral therapy can effectively promote
communication between nurses and patients, improve the adverse psychological state of patients with IUI,
and reduce the number of cases of giving up treatment, which can be applied in clinical practice.

Key words:  Cognitive behavior therapy')" href="#">Cognitive behavior therapy    Intrauterine insemination    Sex hormone    Psychology    rate
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收稿日期:  2021-02-12                     发布日期:  2022-01-28     
基金资助: 厦门市医学优势亚专科建设项目(厦卫科教[2018]296 号)
通讯作者:  任建枝    E-mail:  Email:rjz174@126.com
引用本文:    
连水燕 任建枝. 认知行为疗法对宫腔内夫精人工授精患者临床妊娠结局及心理状态的影响[J]. 发育医学电子杂志, 2022, 10(1): 25-30.
Lian Shuiyan, Ren Jianzhi. Effect of cognitive behavioral therapy on the clinical pregnancy outcome and mental state of patients with intrauterine insemination. Journal of Developmental Medicine(Electronic Version), 2022, 10(1): 25-30.
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