正念瑜伽与音乐疗法对IVF-ET结局及患者心理、生活质量的影响

Effect of mindfulness yoga and music therapy on IVF-ET outcome and psychological quality of life

目的:探讨正念瑜伽与音乐疗法对体外授精-胚胎移植取卵术(in vitro insemination embryo transfer egg retrieval,IVF-ET)结局的干预效果及对患者心理、生活质量的影响。方法:将2020年1月—2021年10月在南通大学附属妇幼保健院生殖医学中心采用长方案促排行IVF-ET治疗的不孕症患者200例为研究对象,根据随机数字表法分为4组,每组各50例,A组在IVF-ET治疗时采用静脉麻醉进行镇痛;在此基础上,B组使用音乐疗法;C组使用正念瑜伽疗法;D组联合使用正念瑜伽与音乐疗法。比较4组患者的疼痛指标、IVF-ET结局指标、心理状态、生活质量、自觉压力和自我效能、睡眠质量的差异。结果:术后即刻及术后1 h的视觉模拟评分(visual analogue scale,VAS)相比,D组<C组<B组<A组(P<0.05);躯体舒适度评分相比,D组>C组>B组>A组(P<0.05);D组穿刺卵泡数、实际获卵数、取卵后第3天胚胎移植比例、妊娠率明显高于A、B、C组(P<0.05),但A、B、C 3组之间的穿刺卵泡数、实际获卵数、取卵后第3天胚胎移植数、妊娠率相比差异无统计学意义(P>0.05);干预后焦虑自评量表(self-rating anxiety scale,SAS)评分、抑郁自评量表(self-rating depression scale,SDS)评分相比,D组<C组<B组<A组(P<0.05);干预后心理状态、生理状态、社会关系、环境状态等世界卫生组织生活质量评估简表(the world health organization quality of life-BREF,WHO-QOL-BREF)评分相比,D组>C组>B组>A组(P<0.05);干预后中文版压力知觉量表(Chinese perceived stress scale,CPSS)评分、一般效能感量表(general perceived self-efficacy scale,GSES)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分相比,CPSS评分、PSQI评分为D组<C组<B组<A组,GSES评分为D组>C组>B组>A组(P<0.05)。结论:正念瑜伽与音乐疗法对IVF-ET患者的干预效果显著,能有效缓解手术疼痛,提高躯体舒适度,减轻心理焦虑、抑郁情绪,降低心理压力,提高自我效能,改善睡眠质量和生活质量,具有积极的临床意义。

Objective:To explore the intervention effect of mindfulness yoga and music therapy on patients undergoing in vitro insemination embryo transfer egg retrieval(IVF-ET).Methods:A total of 200 infertile patients who were treated with IVF-ET from January 2020 to October 2021 in Reproductive Medicine Center of Maternal and Child Health Care Hospital of Nantong University were selected as the research subjects.According to different perioperative nursing methods,they were divided into four groups with 50 cases in each group.Group A was treated with intravenous anesthesia for analgesia during IVF-ET treatment.On this basis,group B was treated with music therapy,group C was treated with mindful yoga therapy,and group D was treated with mindful yoga and music therapy.The pain indicators,IVF-ET outcome indicators,psychological state,quality of life,perceived stress and self-efficacy,and sleep quality of the four groups were compared.Results:Immediately after surgery and 1 h after surgery,visual analogue scale(VAS)of group D<group C<group B<group A(P<0.05);body comfort score of group D>group C>group B>group A(P<0.05).Group D puncture follicle number,the number of eggs,eggs and real 3 d proportion of embryo transfer,the pregnancy rate was obviously higher than group A,group B and group C(P<0.05),but in group A,group B and group C puncture follicle number between three groups,the number of eggs,take actual egg number of 3 d after embryo transfer,pregnancy rate compared with no significant difference(P>0.05).After intervention,the scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were significantly lower in group D than in group C,group B than in group A(P<0.05).After intervention,the world health organization quality of life-BREF(WHO-QOL-BREF)scores of psychological state,physiological state,social relationship and environmental state were higher in group D>group C>group B>group A(P<0.05).Compared with Chinese perceived stress scale(CPSS),general perceived self-efficacy scale(GSES)and Pittsburgh sleep quality index(PSQI),CPSS score and PSQI score were group D<group C<group B<group A,GSES score was group D>group C>group B>group A(P<0.05).Conclusion:The intervention effect of mindfulness yoga and music therapy on IVF-ET patients is significant,which can effectively relieve surgical pain,improve physical comfort,relieve psychological anxiety and depression,reduce psychological stress,improve self-efficacy,improve sleep quality and life quality,and has positive clinical significance.