本文選題：生物反饋 + 體外受精-胚胎移植�。� 參考：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討生物反饋對(duì)初次行體外受精-胚胎移植(IVF-ET)治療的女性患者負(fù)面心理的干預(yù)效果,對(duì)生化妊娠結(jié)局的影響,旨在改善其焦慮抑郁等負(fù)面情緒,增強(qiáng)患者自信心,提高妊娠率。方法:收集某三級(jí)甲等醫(yī)院生殖醫(yī)學(xué)科2015年1月至2016年12月初次接受IVF-ET的女性患者230例。共發(fā)放問(wèn)卷230份,收回223份,有效回收率為96.96%。所有研究對(duì)象均知情同意。符合以下全部條件者方可納入:符合《婦產(chǎn)科學(xué)》第八版關(guān)于不孕癥的診斷標(biāo)準(zhǔn);有生育要求的女性患者,年齡介于21-45歲之間;SAS評(píng)分標(biāo)準(zhǔn)分≥50分或和SDS評(píng)分標(biāo)準(zhǔn)分≥53分;能理解和執(zhí)行治療人員的簡(jiǎn)單指令;因女方輸卵管因素初次接受IVF-ET治療;治療方案均為短效長(zhǎng)方案。排除標(biāo)準(zhǔn):有嚴(yán)重的視覺(jué)障礙或聽(tīng)覺(jué)障礙,影響生物反饋正常進(jìn)行者;伴有理解困難、癡呆、嚴(yán)重心腦腎功能不全及精神病患者;近3個(gè)月內(nèi)服用過(guò)精神類及其他調(diào)節(jié)情緒的藥物。將納入組的60例患者應(yīng)用隨機(jī)數(shù)字表法分為干預(yù)組和對(duì)照組,每組30人,無(wú)脫落病例。對(duì)照組給予常規(guī)健康教育,干預(yù)組對(duì)患者實(shí)施常規(guī)健康教育的同時(shí)給予生物反饋治療。患者在注射促性腺激素第一天接受量表評(píng)估,包括病人基本情況調(diào)查量表、焦慮自評(píng)量表(Self-Rating Anxiety Scale,SAS)、抑郁自評(píng)量表(self-raring depression scale,SDS)、癥狀自評(píng)量表(The self-report symptom inventory,SCL-90)。胚胎移植術(shù)后第14天早晨8:00采集患者靜脈血標(biāo)本檢測(cè)人絨毛膜促性腺激素(Human choionic gonadotophin),確定是否生化妊娠。安排患者在等待HCG值結(jié)果出來(lái)以前再次進(jìn)行SAS,SDS,SCL-90量表測(cè)評(píng)。應(yīng)用SPSS17.0統(tǒng)計(jì)學(xué)軟件將收集到的資料進(jìn)行分析。計(jì)量資料進(jìn)行t檢驗(yàn),計(jì)數(shù)資料應(yīng)用χ2檢驗(yàn)。P0.05認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1對(duì)照組治療前后患者的焦慮、抑郁等負(fù)面心理未發(fā)生明顯變化,差異無(wú)統(tǒng)計(jì)學(xué)意義。2干預(yù)組治療前后患者的強(qiáng)迫癥狀、焦慮、抑郁、負(fù)面心理發(fā)生明顯變化,差異有統(tǒng)計(jì)學(xué)意義。3干預(yù)組與對(duì)照組治療后焦慮、抑郁、強(qiáng)迫癥狀的減分差有差異,差異有統(tǒng)計(jì)學(xué)意義。4干預(yù)組妊娠的人數(shù)為17人,妊娠率為56.7%。對(duì)照組妊娠的人數(shù)為13人,妊娠率為43.3%。干預(yù)組妊娠率明顯高于對(duì)照組,但兩組數(shù)據(jù)差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論:1初次接受IVF-ET的女性焦慮、抑郁等負(fù)面心理發(fā)生率明顯高于正常人群,本研究中焦慮的發(fā)生率為17.9%,抑郁的發(fā)生率為26.9%,焦慮抑郁共存率為9.87%。2生物反饋干預(yù)降低了不孕癥患者的焦慮、抑郁等負(fù)面心理。3應(yīng)用生物反饋干預(yù)患者的生化妊娠率為56.7%,明顯高于常規(guī)健康教育患者43.3%的生化妊娠率,值得在不孕不育患者中推廣應(yīng)用。
[Abstract]:Objective: to explore the effect of biofeedback on the negative psychology of female patients treated with IVF-ETT for the first time, and the effect of biofeedback on the outcome of biochemical pregnancy, in order to improve their negative emotions such as anxiety and depression and enhance their self-confidence.Increase the pregnancy rate.Methods: 230 female patients who received IVF-ET from January 2015 to early December 2016 in a department of reproductive medicine of Grade 3A Hospital were collected.A total of 230 questionnaires were sent out, 223 were recovered, and the effective recovery rate was 96.9661.All subjects were informed consent.Only those who met the following conditions could be included: those who met the criteria for diagnosis of infertility in the eighth edition of Gynecology and Gynecology; the female patients with fertility requirements had a score of 鈮，

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