产科女医生精神紧张对内分泌功能的影响

Effects of Mental Tension on the Endocrine Function of Female Obstetrician

目的:探讨女性产科医生的精神紧张压力对内分泌功能的影响。方法:采用整群抽样(横断面)方法,抽取9家医院及妇幼保健院产科女医生491人(研究组),心血管内科女医生216人(对照组),对两组医师进行CHQ、JCQ及产科医生紧张量表调查,同时检测空腹静脉血儿茶酚胺水平及血压,比较两组女医生性激素与精神紧张程度和相关性。结果:(1)研究组GHQ总分≥15分精神紧张者的比例高于对照组(P<0.01),JCQ显示研究组工作需求评分高于对照组(P<0.01),而社会支持度评分低于对照组(P<0.01)医生紧张量表显示研究组的工作强度、工作倦怠程度、医患关系以及工作特点评分均高于对照组(P<0.001);(2)泌乳素、睾酮水平研究组高于对照组(P<0.001、P<0.05),排卵期雌二醇及孕酮均低于对照组P<0.01。(3)研究组女性内分泌功能紊乱临床症状程度明显者高于对照组P<0.001。两组对比,研究组精神紧张和女性内分泌功能状况异常明显高于对照组。计算得出精神紧张与性激素的异常变化有密切相关性。结论:(1)GHQ-12提示研究组在产科工作环境中精神健康伤害发病率高于对照组;(2)JCQ提示在医院产科工作环境中造成医生紧张的因素高于内科;(3)产科医生紧张量表提示研究组医生精神紧张程度远远高于对照组。产科组精神紧张伤害和女性内分泌功能紊乱症状的程度高于对照组。而产科紧张环境中出现的精神紧张压力反应与女性内分泌功能异常程度是密切相关的。

Objective： To explore the effects of mental tension on endocrine function of female obste- trician. Methods： A total of 491 female obstetricians （study group） and 216 female doctors of cardio- vascular department （control group） were selected. CHQ, JCQ and obstetrician stress scale survey were carried out in the two groups, and blood eatecholamine level and blood pressure value were detec- ted. The correlation of sex hormones with mental tension degrees was analyzed. Results： （1） The pro- portion of doctors whose GHQ 〉I 15 points in study group was higher than that in control group （ P 〈 0. 01 ） ; JCQ survey results showed that work demand in study group was higher than that in control group（ P 〈 0.01 ） ,and social support score was lower than that in controc group（P 〈 0. 01 ）. Obstetri- cian stress scale survey results showed that work strength, job burnout degree, doctor ship and job characteristic scores in study group were higher than those in control group Prolactin and testosterone levels in study group were higher than those in control group - patient relation- （P 〈0.01）. （2） （P 〈0.001 and P 〈 0.05）, estradiol and progesterone levels in ovulation period in study group were lower than those in control group,（P 〈0.01）. （3） Mental tension was correlated with changes of sex hormones. Conclu-sions： Mental tension degrees and female endocrine function disorder degrees of female obstetricians are higher than those in controls, and mental tension is correlated with changes of sex hormones.