不孕不育风险因素分析及动漫宣教短片的预防效果

Risk Factors for Infertility and Preventive Effects of Short Education Animations

目的分析不孕不育相关风险因素并评估动漫宣教短片的预防效果。方法选取2015年1月-2017年12月西安市第四医院生殖医学科的不孕不育夫妇患者400对(病例组)和体检科的健康夫妇400对(对照组)。对所有研究对象进行问卷调查,主要调查内容包括:身高、体质量、文化程度、工作强度、精神压力、生殖类相关疾病等。此外,将病例组随机分为A和B两组,B组仅进行专家讲座及宣传册发放;而A组在此基础上另外进行动漫宣教短片培训。培训前后,分别对A、B两组进行预防知识测试。结果两组男性的BMI指数、高温作业、精神压力、睾丸疾病和输精管疾病有显著统计学差异(P<0.001);而文化程度和工作强度无统计学差异(P>0.05)。两组女性的BMI指数、清宫术史、精神压力、子宫疾病、卵巢疾病和输卵管疾病具有显著统计学差异(P<0.001);而文化程度和工作强度无统计学差异(P>0.05)。多元Logistic回归分析发现BMI过高、睾丸和输精管疾病均会影响男性不孕不育(P<0.05);而清宫术、精神压力、子宫、卵巢和输卵管疾病均会影响女性不孕不育(P<0.05)。培训前,A、B两组对于预防知识的熟悉程度无统计学差异(P>0.05)。培训后,A、B两组的熟悉程度都显著提高(P<0.05)。此外,A组的熟悉程度高于B组(P<0.05)。结论 BMI过高、睾丸和输精管疾病会影响男性不孕不育;而清宫术、精神压力、子宫、卵巢和输卵管疾病会影响女性不孕不育。动漫宣教短片的预防效果良好,应广泛推广。

Objective To analyze the risk factors related to infertility and evaluate the preventive effect of short education animations. Methods A total of 400 couples with infertility（ cases） and another 400 healthy couples（ controls） were recruited at the Department of Reproductive Medicine and Physical Examination Center of the Xi＇an No.4 Hospital from January 2015 to December 2017. A questionnaire survey was conducted among these subjects,involving height,weight,education levels,work intensity,mental stress,and reproductive related diseases. In addition,the case group was randomly divided into groups A and B.Group B was offered expert lectures and brochures only while group A was additionally provided with short education animations.Tests on knowledge of prevention were performed in the two groups before and after training.Results There was statistically significant difference in BMI,high-temperature operation,stress,testicular disease,and vas deferens disease among men between the cases and controls（ P〈0.001）,but there was no statistical difference in educational levels or work intensity（ P〉0.05）. There was statistically significant difference in BMI,history of uterine dissection,mental stress,uterine disease,ovarian disease,and fallopian tube disease among women between the cases and controls（ P〈0.001）,but there was no significant difference in educational levels or work intensity（ P〉0.05）. Multivariate logistic regression analysis results showed that high BMI,testicular and vas deferens diseases all affected men＇s infertility（ P〈0.05）,while uterine surgery,mental stress,uterus,ovary and fallopian tube diseases all affected women＇s infertility（ P〈0.05）. Before training,there was no statistically significant difference between group A and group B in levels of knowledge of prevention（ P〈0.05）. After training,the familiarity of the two groups was significantly improved（ P〈0.05）. In addition,the level of knowledge of prevention was better in group A than in group B（ P〈0.05）.Conclusion High BMI,testicular and vas deferens affect men＇s infertility,whereas uterine aggression,mental stress,uterus,ovaries,and fallopian tube disease affect women＇s infertility. The short education animation has good preventive effect and should be widely used.