社会心理干预对接受体外受精-胚胎移植治疗不孕症患者妊娠结局的影响

Effects of Psychosocial Intervention on Pregnancy Outcomes in Infertility Patients Treated by In Vitro Fertilization and Embryo Transplantation

目的：分析社会心理干预对接受体外受精-胚胎移植（IVF-ET）治疗不孕症患者妊娠结局的影响。方法：选取2015年5月至2017年5月我院接受IVF-ET治疗的不孕症患者110例为研究对象,按入院顺序编号后采用随机数表法分为观察组、对照组各55例,在进入IVF用药周期开始对照组实施常规护理干预,观察组在此基础上实施社会心理干预,采用焦虑自评量表（SAS）、抑郁自评量表（SDS）、症状自评量表（SCL-90）、纽芬兰纪念大学幸福度量表（MUNSH）评价两组焦虑抑郁情绪、心理健康状况及幸福感,并记录临床妊娠结局（获卵率、受精率、卵裂率、优质胚胎率、临床妊娠率）。结果：观察组干预后SAS评分、SDS评分明显低于对照组（t=-11.194,-8.813;P〈0.001）;干预后观察组SCL-90评分总均分及各因子低于对照组（t=-8.179,-6.775,-9.728,-17.928,-2.161,-7.534,-9.845,-4.131,-2.163,-9.429,-7.674;P〈0.05）;干预后观察组MUNSH总分及正义情感（PA）、正性体验（PE）得分高于对照组（t=11.646,4.132,6.798;P〈0.001）,负性情感（NA）、负性体验评分（NE）低于对照组（t=-10.549,-2.225;P〈0.05）;观察组优质胚胎率83.64%、临床妊娠率74.55%高于对照组63.64%、54.55%（χ~2=5.666,4.807;P〈0.05）,两组获卵率、受精率、卵裂率对比差异无统计学意义（P〉0.05）。结论：社会心理干预可明显减轻IVF-ET治疗不孕症患者焦虑抑郁情绪,提高其心理健康水平及幸福感,继而改善其妊娠结局,值得在临床推广实践。

Objective：To analyze the effects of psychosocial intervention on pregnancy outcomes in infertility patients treated with in vitro fertilization and embryo transplantation（IVF-ET）.Methods：A total of 110 cases of infertility patients treated with IVF-ET in our hospital from May 2015 to May 2017 were selected for the study and numbered by admission sequence,and then divided into the observation group and the control group with 55 cases in each group according to the random number table method.The control group was given routine nursing intervention when entering the IVF medication cycle,and the observation group was given psychosocial intervention on this basis.The self-rating anxiety scale（SAS）,self-rating depression scale（SDS）,symptom checklist（SCL-90）,Memorial University of Newfoundland scale of happiness（MUNSH）were used to evaluate the anxiety and depression,mental health and happiness of the two groups,and the clinical pregnancy outcomes（ovum rate,fertilization rate,cleavage rate,high quality embryo rate and clinical pregnancy rate）were recorded.Results：The scores of SAS and SDS in the observation group were significantly lower than those in the control group（t=-11.194,-8.813;P〈0.001）.After intervention,the total SCL-90 score and the factors scores in the observation group were lower than those in the control group（t=-8.179,-6.775,-9.728,-17.928,-2.161,-7.534,-9.845,-4.131,-2.163,-9.429 and-7.674;P〈0.05）.After intervention,the total score of MUNSH and the scores of justice feelings（PA）and positive experience（PE）were higher in the observation group than those of the control group（t=11.646,4.132,6.798;P〈0.001）while the scores of negative emotion（NA）and negative experience（NE）were lower than those in the control group（t=-10.549,-2.225;P〈0.05）.The high-quality embryo rate and the clinical pregnancy rate were higher in the observation group than in the control group（83.64% vs.63.64% and 74.55% vs.54.55%）（χ~2=5.666,4.807;P〈0.05）,and there was no significant difference between the two groups in the ovum rate,fertilization rate and cleavage rate（P〉0.05）.Conclusion：Psychosocial intervention can significantly reduce the anxiety and depression of infertility patient with IVFET treatment,improve their mental health and happiness and the pregnancy outcomes.