新疆地区少数民族子宫肌瘤患者GnRH-a联合反加疗法的认知调查及健康教育新模式探讨

Cognition investigation of GnRH-a in combination with add-back therapy in ethnic minority patients with uterine leiomyoma in Xinjiang District and discussion the new model of health education

目的调查新疆地区少数民族子宫肌瘤患者促性腺激素释放激素激动剂(GnRH-a)联合反加疗法的认知水平,及健康教育新模式探讨。方法选取2017年1月~2018年12月新疆医科大学第一附属医院接受GnRH-a联合反加疗法的少数民族子宫肌瘤患者80例作为观察对象,按照随机数字表法分为对照组和观察组,每组各40例。对照组给予常规健康教育,观察组给予多维度医护协作模式健康教育。比较两组子宫肌瘤GnRH-a联合反加疗法认知得分、激素水平、药物不良反应及骨密度(BMD)水平。结果健康教育前,两组子宫肌瘤GnRH-a联合反加疗法认知得分比较,差异无统计学意义(P>0.05)。健康教育后,两组子宫肌瘤GnRH-a联合反加疗法认知得分均升高且观察组高于对照组,差异有统计学意义(P<0.05)。两组促卵泡成熟激素(FSH)、黄体生成激素(LH)、雌二醇(E 2)水平均降低,且观察组FSH、LH水平低于对照组,E 2水平高于对照组,差异均有统计学意义(均P<0.05)。两组第1~4腰椎(L 1~L 4)及股骨头BMD水平均降低,且观察组高于对照组,差异均有统计学意义(均P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论新疆地区少数民族子宫肌瘤患者GnRH-a联合反加疗法的认知水平低,而多维度医护协作模式健康教育能够提高其认知水平,改善性激素水平,减少不良反应,并且对骨质丢失影响小,值得应用。

Objective To survey cognition level of gonadotrophin releasing hormone agonist(GnRH-a)in combination with add-back therapy in ethnic minority patients with uterine leiomyoma in Xinjiang District and discuss the new model of health education.Methods From January 2017 to December 2018,80 ethnic minority cases with uterine leiomyoma received GnRH-a combination with add-back therapy in the First Affiliated Hospital of Xinjiang Medical University were collected as observational objects.According to the random number table method,they were divided into control group and observation group,with 40 cases in each group.Control group was given conventional health ed-ucation,while observation group was given multi-dimensional medical care integration mode health education.Cogni-tive scores of GnRH-a combined with add-back therapy,levels of hormone,adverse reactions and levels of bone min-eral density(BMD)were compared between two groups.Results Before health education,there were no statistically sig-nificant differences in the cognitive scores of GnRH-a combination with add-back therapy between two groups(P>0.05).After health education,the cognitive scores of GnRH-a combination with add-back therapy in both groups were increased,and observation group was higher than control group,with statistically significant differences(P<0.05).The levels of follicule-stimulating hormone(FSH),lutropin(LH),estradiol(E 2)was decreased in both groups,and the levels of FSH,LH in observation group was lower than those in control group,while the level of E 2 in observation group was higher than that in control group,with statistically sig-nificant differences(all P<0.05).The BMD levels of 1-4 lumbar spine(L 1-L 4)and femoral head in both groups were decreased,and observation group was higher than control group,and the differences were statistically sig-nificant(all P<0.05).The incidence of adverse reactions in observation group were lower than that in control group,and the differences were statistically significants(P<0.05).Conclusion Ethnic minority patients with uterine leiomy-oma in Xinjiang District has low level of cognition of GnRH-a combined with add-back therapy.And multi-dimen-sional medical care integration mode health education can increase cognition level,improve levels of sex hormones,re-duce incidences of adverse reactions and has less influences on bone loss.