综合护理干预对体外受精-胚胎移植术后并发结核病转归的影响

Effect of comprehensive nursing intervention on the return to tuberculosis after in vitro fertilization-embryo transfer

目的探究综合护理干预对体外受精-胚胎移植(IVF-ET)术后并发结核病(TB)转归的影响。方法选取本院结核科2016年1月至2018年12月收治的20例IVF-ET术后并发TB患者为研究对象。给予患者综合护理干预(心理护理、结核病健康宣教、妇产科护理、用药护理及其他护理),分析患者的妊娠转归情况、临床症状、营养指标[体重指数(BMI)、血红蛋白(Hb)、白蛋白(ALB)]及入院时和出院时的心理状态。结果自然流产或不全流产7例(35.0%),人工流产11例(55.0%),早产2例(10.0%)。护理1个月后,患者的咳嗽、咳痰、发热、盗汗、纳差症状人数占比低于护理前,差异具有统计学意义(P<0.05)。护理1个月后,患者的BMI及Hb、ALB水平均高于护理前,差异具有统计学意义(P<0.01)。出院时,患者的躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对和其他项目的评分均低于入院时,差异具有统计学意义(P<0.01)。结论IVF-ET术后并发TB患者早期确诊后,在做好抗结核治疗的前提下,给予患者综合护理干预可改善其负面心理、临床症状和营养指标,值得临床推广应用。

Objective To explore the effect of comprehensive nursing intervention on the return to tuberculosis(TB)after in vitro fertilization-embryo transfer(IVF-ET).Methods Twenty patients with TB after IVF-ET in the tuberculosis department of our hospital from January 2016 to December 2018 were selected as the study objects.Patients were given comprehensive nursing intervention(psychological nursing,tuberculosis health education,obstetrics and gynecology nursing,medication nursing and other nursing).The pregnancy outcome,clinical symptoms,nutritional indexes[body mass index(BMI),hemoglobin(Hb),albumin(ALB)]and psychological status at admission and discharge were analyzed.Results There were 7 cases of spontaneous or incomplete abortion(35.0%),11 cases of induced abortion(55.0%),and 2 cases of premature birth(10.0%).After one month of nursing,the proportions of patients with cough,expectoration,fever,night sweat and anorexia were less than those before nursing,and the differences were statistically significant(P<0.05).After one month of nursing,the BMI,Hb and ALB levels of the patients were higher than those before nursing,and the differences were statistically significant(P<0.01).At discharge,the scores of somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility and other items were lower than those at admission,and the differences were statistically significant(P<0.01).Conclusion After early diagnosis of TB patients after IVF-ET,comprehensive nursing intervention can improve negative psychology,clinical symptoms and nutritional indicators under the premise of anti-tuberculosis treatment,which is worthy of clinical promotion and application.