分阶段护理联合促排卵在肥胖型多囊卵巢综合征不孕患者中的应用效果分析

Effect of Phased Nursing and Ovulation Promotion on the Condition Improvement in Infertile Patients with Obese Polycystic Ovarian Syndrome

目的:探讨肥胖型多囊卵巢综合征不孕患者应用分阶段护理联合促排卵治疗的应用效果,为临床治疗提供依据。方法:选取2019年1月—2021年1月泉州市妇幼保健院收治的60例肥胖型多囊卵巢综合征不孕患者作为研究对象,依据随机数表法将纳入患者分为对照组和观察组,每组各30例。对照组实施常规护理干预3个月后予以药物促排卵治疗,观察组实施分阶段护理3个月后予以药物促排卵治疗。比较两组患者糖代谢指标[空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛抵抗指数(HOMA-IR)]、性激素水平[睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)]、凝血纤溶指标[凝血因子Ⅷ(FⅧ)、凝血因子-Ⅹ(FⅩ)、D二聚体(D-D)、纤溶酶原激活抑制物-1(PaI-1)]、卵巢功能及妊娠结局。结果:干预后,两组患者FPG指标比较,差异无统计学意义(t=0.313,P>0.05),观察组患者FINS、HOMA-IR指标均低于对照组,差异有统计学意义(t=9.602、7.095,P<0.05)。干预后,观察组患者T、LH、FSH水平均低于对照组,差异有统计学意义(t=4.005、7.875、5.775,P<0.05)。干预后,观察组患者FⅧ、FX、D-D、Pa I-1指标均明显低于对照组,差异有统计学意义(t=3.686、2.533、2.167、3.049,P<0.05)。干预后,观察组患者卵泡发育体积、卵泡数量均明显低于对照组,子宫内膜厚度高于对照组,差异有统计学意义(t=5.455、4.383、4.013,P<0.05)。观察组患者妊娠成功率明显高于对照组,差异有统计学意义(χ^(2)=4.267,P<0.05)。结论:肥胖型多囊卵巢综合征不孕患者应用分阶段护理联合促排卵治疗,能够改善患者糖代谢指标、性激素水平、凝血纤溶指标及卵巢功能,提高妊娠成功率。

Objective:To explore the application effect of applying staged care combined with ovulation promotion therapy in obese polycystic ovary syndrome infertility patients to provide a basis for clinical treatment.Methods:60 patients with obese polycystic ovary syndrome infertility admitted to the hospital from January 2019 to January 2021 were selected for the study,and the included patients were divided into control group and observation group based on the random number table method,with 30 cases in each group.The control group was given pharmacological ovulation treatment for 3 months after conventional nursing intervention,while the observation group was given pharmacological ovulation treatment after 3 months of phased care.The glucose metabolism index(fasting blood sugar[FPG],fasting resistance index[HOMA-IA]),sex hormone level(andorstenedione[T],luteinizing hormone[LH],follicle stimulating hormone[FSH]),coagulation and fibrinolysis index(coagulation factor Ⅷ[FⅧ],coagulation factor Χ[FⅩ])D-dimer[D-D],fibrinogen activetor inhibitor-1[PaI-1],ovarian function and pregnancy outcome were compared between the two groups.Results:After the intervention,there was no statistically significant difference in the FPG index between the two groups(t=0.313,P>0.05).The observation group had lower FINS and HOMA-IR indexes than the control group,and the differences were statistically significant(t=9.602,7.095,P<0.05).After the intervention,T,LH,and FSH levels were lower in the observation group than in the control group,with statistically significant differences(t=4.005,7.875,5.775,P<0.05).After the intervention,FⅧ,FⅩ,D-D,and PaI-1 indexes were significantly lower in the observation group than in the control group,with statistically significant differences(t=3.686,2.533,2.167,3.049,P<0.05).After the intervention,the follicle development volume and follicle number in the observation group were significantly lower than those in the control group,and the endometrial thickness was higher than that in the control group,with statistically significant differences(t=5.455,4.383,4.013,P<0.05).The pregnancy success rate was significantly higher in the observation group than in the control group,and the difference was statistically significant(χ^(2)=4.267,P<0.05).Conclusion:The application of staged care combined with ovulation promotion therapy in obese polycystic ovary syndrome infertile patients can improve glucose metabolism index,sex hormone level,coagulation and fibrinolytic index and ovarian function,and increase the pregnancy success rate.