电话随访对子宫腺肌瘤术后 GnRH-a治疗效果的影响

目的：观察电话随访护理干预对促性腺激素释放激素激动剂（ GnRH-a）治疗子宫腺肌瘤剔除术患者临床效果的影响。方法选择2009年1月—2011年12月行子宫腺肌瘤剔除术后联合GnRH-a治疗的115例患者，按照随机数字表法随机分成研究组55例和对照组60例。研究组对患者进行电话跟踪随访，给予饮食、休息、活动、生活、精神等方面正向的引导、持续的心理干预、复诊提醒及不良反应的应对措施等护理干预。对照组未进行电话随访护理干预，按常规主管医生门诊定期随访复诊。结果研究组患者痛经症状缓解或消失者53例（96．36％），术后无明显复发者52例（94．54％），经量减少经期缩短者52例（94．54％），对照组依次为49（89．09％），51（92．72％），50（90．90％），两组比较差异无统计学意义（χ2值分别为1．21，0．00，0．13；P＞0．05）。两组患者潮热盗汗、皮疹痤疮、恶心头痛、四肢乏力、关节酸痛、烦躁抑郁等发生率比较，差异有统计学意义（χ2值分别为6．15，6．15，4．45，5．04，4．25，4．25；P＜0．05）。两组患者坚持规律用药、定期复查、改变不良生活习惯与正确应对不良反应的依从性比较差异有统计学意义（χ2值分别为5．49，7．31，14．31，10．45；P＜0．05）。结论电话随访护理干预可提高子宫腺肌瘤剔除术后联合GnRH-a治疗患者的依从性，患者能正确有效应对不良反应，降低不良反应发生率，增进护患关系。

Influence of follow-up telephone on the effect of GnRH-a treatment among uterine adenomyoma postoperative patients

Objective By means of telephone follow-up care intervention, we aimed to explore the effect of clinical efficacy and the ability to cope with adverse reaction among uterine adenomyoma postoperative patients after receiving GnRH-a treatment.Methods From January 2009 to December 2011, 115 patients who underwent uterine adenomyoma surgery combined with GnRH-a treatment were divided into two groups.The research group of 55 patients received positive guidance of food, rest, activities, life, spirit and so on through telephone, also a continuous psychological intervention of subsequent visit reminding and the solutions to adverse reactions.Then the 60 cases in the control group only received the conventional outpatient follow-up at regular intervals according to their competent doctor, without any telephone follow-up of nursing intervention.Results In the research group, the dysmenorrhea of 53 patients （ 96.36%） was relieved or disappeared, 52 patients （94.54%） did not relapse after surgery.The menstrual blood volume was decreased and the period of the menstrual was reduced within 52 patients （94.54%）.Those values of the control group were 49（89.09%）, 51（92.72%） and 50（90.90%）.There was no significant difference between groups （χ2 =1.21, 0.00, 0.13, respectively;P 〉0.05）.After the treatment of GnRH-a, the adverse reactions such as hot flashes, night sweats, skin rash as well as acne, and the compliance were significantly improved （χ2 =6.15, 6.15, 4.45, 5.04, 4.25, 4.25, respectively; P〈0.05）.There were also significant differences in keeping medication, regular examine, changing bad habits and the compliance of coping with the adverse reaction （χ2 =5.49, 7.31, 14.31, 10.45, respectively;P〈0.05）.Conclusions Telephone follow-up care intervention can improve the compliance of uterine adenomyoma postoperative patients receiving GnRH-a treatment, reduce the adverse reaction and help patients cope with adverse reactions effectively in the right way, and lead to better relationship