催眠训练对冻融胚胎移植患者身心状态的影响研究

Study on effect of hypnotic training on physical and mental state of patients undergoing frozen-thawed embryo transfer

目的研究催眠训练对冻融胚胎移植(FET)患者焦虑、抑郁等身心状态的影响,探索心理干预在辅助生殖领域应用的可行性。方法195例FET患者,在周期治疗中各环节点均常规给予健康宣教和心理护理。入组患者移植日术前增加一堂约20 min的催眠训练课。比较所有FET患者催眠训练前后贝克抑郁量表(BDI)、贝克焦虑量表(BAI)评分,BDI分度,BAI分度,脉率,选择负性情绪词汇情况,选择正性情绪词汇情况。结果FET患者BDI评分由催眠训练前的(3.58±4.87)分下降至催眠训练后的(1.03±2.43)分,BAI评分由催眠训练前的(8.02±8.04)分下降至催眠训练后的(2.59±4.41)分(P<0.05)。催眠训练后,BDI分度为0~10分的患者占比97.95%与催眠训练前的91.28%相比较显著升高,11~45分的患者占比2.05%与催眠训练前的8.72%相比显著降低(P<0.05)。FET患者催眠训练后BAI分度为0~10分占比85.13%相较于催眠训练前的44.62%升高,11~20分的占比12.82%较催眠训练前的49.74%下降(P<0.05);催眠训练后21~30分、31~50分的占比也呈下降趋势,但由于样本量少,与催眠训练前相比无明显差异(P>0.05)。FET患者催眠训练后的脉率为(75.5±7.8)次/min较催眠训练前的(79.7±8.1)次/min显著下降,有明显差异(P<0.05)。催眠训练后选择负性情绪词汇人次明显减少,其中担心、紧张、焦虑、紧绷、心慌、烦躁、害怕、泄气、悲伤选择率分别为21.03%、9.23%、2.56%、8.21%、0、4.10%、6.67%、1.54%、0,均低于催眠训练前的76.41%、62.56%、34.87%、28.72%、23.59%、21.03%、17.95%、6.15%、5.13%,有明显差异(P<0.05);由于选择崩溃的人次较少,催眠训练前后数据无明显差异(P>0.05)。所列10个正性词汇中,催眠训练后有放松、平静、舒适、踏实、信心、温暖、安全、愉快选择率80.51%、78.97%、40.51%、36.41%、32.31%、22.05%、12.82%、21.03%,与催眠训练前的13.33%、26.15%、7.69%、6.67%、19.49%、6.67%、5.13%、12.82%比较,有明显差异(P<0.05);兴趣、希望选择率分别为1.54%、30.77%,与与催眠训练前的0、30.26%比较,无明显差异(P>0.05)。结论催眠训练能显著降低FET患者的焦虑抑郁水平,减少患者负性情绪,增加正性情绪,提升患者的身体、心理舒适度和就医感受,具有良好的应用推广价值。

Objective To study the influence of hypnotic training on anxiety and depression of frozen-thawed embryo transfer(FET)patients,and explore the feasibility of psychological intervention in the field of assisted reproduction.Methods 195 patients undergoing FET were routinely given health education and psychological nursing at all points in the cycle treatment.A 20 min of hypnotic training was conducted before the FET on the day of transfer.All FET patients were compared before and after hypnotic training in terms of Beck depression inventory(BDI)score,Beck anxiety inventory(BAI)score,BDI scoring,BAI scoring,pulse rate,selection of negative emotional words and selection of positive emotional words.Results The FET patients'BDI scores decreased from(3.58±4.87)points before hypnotic training to(1.03±2.43)points after hypnotic training,and BAI scores decreased from(8.02±8.04)points before hypnotic training to(2.59±4.41)points after hypnotic training(P<0.05).After hypnotic training,the percentage of patients with BDI scoring of 0-10 points was 97.95%,which was significantly higher than 91.28%before hypnotic training;the percentage of patients with BDI scoring of 11-45 points was 2.05%,which was significantly lower than 8.72%before hypnotic training(P<0.05).After hypnotic training,patients with BAI scoreing of 0-10 points accounted for 85.13%,which increased compared with 44.62%before hypnotic training;patients with BAI scoreing of 11-20 points accounted for 12.82%,which decreased compared with 49.74%before hypnotic training(P<0.05).After hypnotic training,patients with BAI scoreing of 21-30 points and 31-50 points also showed a downward trend,but because of the small sample size,there was no significant difference compared with before hypnotic training(P>0.05).The pulse rate of FET patients after hypnotic training was(75.5±7.8)beats/min,which decreased significantly compared with(79.7±8.1)beats/min before hypnotic training,and the difference was significant(P<0.05).After hypnotic training,the selection of negative emotional words decreased significantly;the selection rates of worry,nervousness,anxiety,tightness,panic,irritability,fear,discouragement,and sadness were 21.03%,9.23%,2.56%,8.21%,0,4.10%,6.67%,1.54%,and 0,which were lower than 76.41%,62.56%,34.87%,28.72%,23.59%,21.03%,17.95%,6.15%,and 5.13%before hypnotic training,and the difference was significant(P<0.05).There was no difference in the data before and after hypnotic training due to the low selection of collapse(P>0.05).Among the 10 positive words listed,the selection rates of relaxation,calmness,comfort,steadfastness,confidence,warmth,safety,and pleasure after hypnosis training were 80.51%,78.97%,40.51%,36.41%,32.31%,22.05%,12.82%,and 21.03%after hypnotic training,which were significantly different from 13.33%,26.15%,7.69%,6.67%,19.49%,6.67%,5.13%,and 12.82%before hypnotic training(P<0.05).The selection rates of interest and hope were 1.54%and 30.77%,and there was no significant difference compared to the 0%and 30.26%before hypnotic training(P>0.05).Conclusion Hypnotic training can significantly reduce the level of anxiety and depression in patients with FET,reduce negative emotions,increase positive emotions,and improve physical and psychological comfort and medical experience,which have great value in application.