放松训练在妊娠期高血压疾病治疗中的应用

Application of relaxation training in treatment of hypertensive disorder complicating pregnancy

目的 探讨放松训练在妊娠期高血压疾病治疗中的应用,研究放松训练对妊娠期高血压疾病临床疗效的影响.方法 采用硫酸镁和常规内科治疗为对照组,硫酸镁加用放松训练为研究组,研究组和对照组入组人数均为82例.采用测量血压及症状改变、症状自评量表、汉密尔顿抑郁量表、汉密尔顿焦虑量表分别用于评价患者的临床疗效和自觉症状的改善水平,并对数据进行统计分析.量表评定时间为参加研究的第0周和第2周.结果 研究组和对照组头痛头晕发生率、平均动脉压、尿蛋白含量、产后并发症比较差异均无统计学意义（均P〉0.05）.研究组产后出血量明显少于对照组（t=2.18,P〈0.05）.治疗后两组间妊娠期高血压疾病类型的平均动脉压、产后出血量比较差异均有统计学意义（t值分别为3.16、2.53,均P〈0.05）;子痫前期轻度、子痫前期重度类型的产后出血量比较差异也均有统计学意义（t值分别为2.37、2.41,均P〈0.05）.研究组的症状自评量表总分,抑郁、焦虑、敌对3个因子分,汉密尔顿抑郁量表,汉密尔顿焦虑量表减分率在治疗前后有明显改变,其差异均有统计学意义（t值分别为2.56、2.32、2.68、2.16、3.97、4.38,均P〈0.05）.对照组的症状自评量表总分和各因子分、汉密尔顿抑郁量表、汉密尔顿焦虑量表减分率比较差异均无统计学意义（均P〉0.05）.结论 妊娠期高血压疾病患者存在明显的心理问题,以抑郁、焦虑、敌对为主.放松训练可有效地改善临床症状、自觉症状和心理症状,操作简单可行,值得在妇产科推广.

Objective To investigate the application and clinical effect of relaxation training in the treatment of hypertensive disorder complicating pregnancy. Methods Both the control group treated with magnesium sulfate and conventional medical treatment and the study group treated with magnesium sulfate and relaxation training consisted of 82 cases. Blood pressure and symptom changes of both groups were measured. Symptom checklist-90 （SCL-90）, Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） were used to assess the clinical efficacy and symptom change. The data was analyzed, and the evaluating time of scales was 0 and 2 weeks after objects participated the study. Results There was no significant difference between the study group and the control group in the incidence of headache and dizziness, mean arterial pressure, urine protein content and post-natal complications （ all P 〉 0. 05 ）. The postpartum hemorrhage volume of the study group was significantly less than that of the control group （ t = 2.18, P 〈 0.05 ）. The differences in the postpartum hemorrhage volume and the mean arterial pressure of the types of hypertensive disorder complicating pregnancy were significant between two groups after treatment （ t was 3.16 and 2.53 respectively, P 〈 0.05 ）. The difference in the postpartum hemorrhage volume in the type of mild preeclampsia and severe preeclampsia was significant between two groups （t was 2.37 and 2.41 respectively, P 〈0.05）. The total score of SCL-90, scores of depression, anxiety and hostility, HAMD, HAMA of the study group reduced significantly after treatment, and the difference was significant （t was 2.56, 2.32, 2.68, 2. 16, 3.97 and 4.38 respectively, all P 〈0.05）. But they didn＇ t change significantly in the control group （ all P 〉 0.05 ）. Conclusion The patients with hypertensive disorder complicating pregnancy have obvious psychological problems, including depression, anxiety and hostility. The relaxation training can effectively improve the clinical symptoms, subjective symptoms and psychological symptoms. The operation of relaxation training is simple and feasible. It is worth promoting in the department of obstetrics and gynecology.