产妇产后抑郁症相关因素的分析

目的:了解影响产妇产后抑郁症的相关因素,并提出相对应的心理护理干预措施。方法:采用抑郁自评表(SDS)和焦虑自评量表(SAS)以及自行设计的调查问卷对500例产妇产后的抑郁心理状态和影响产后抑郁症的相关因素进行调查分析。     

中晚期妊娠情绪焦虑抑郁情况调查及其相关因素分析

目的：调查中晚期妊娠情绪焦虑抑郁发生率与特点,并进行因素分析,为开展防治工作提供借鉴。方法：对接收的280例孕产妇行问卷调查与焦虑、抑郁自测的,行相关性分析。结果：抑郁发生率10.71%、焦虑发生率15.71%,抑郁兼焦虑发生率5.71%,合计率20.71%;同一因素下,受教育年限、孕周、流产史、生产史不同患者抑郁、焦虑、抑郁焦虑发生率差异具有统计学意义（P＜0.05）,受教育年限≤9年、有流产史、孕周＞37周成为独立危险因素,OR危险比分别为1.13、1.53、1.23,差异具有统计学意义（P＜0.05,OR≥1,B＞0）。结论：低文化水平、有流产史、临产孕产妇,发生抑郁与焦虑发生率较高;应密切注意有以上危险指征者孕产妇,给予适当的心理支持。     

妇科恶性肿瘤患者术后静脉血栓栓塞的高危因素分析

目的:探讨妇科恶性肿瘤患者术后静脉血栓栓塞疾病(VTE)发生的危险因素及其预防措施。方法:回顾分析32例北京大学人民医院诊治的术后VTE的妇科恶性肿瘤患者临床资料,并与具有相同高危因素,包括高血压、糖尿病、高血脂但术后未发生VTE的61例妇科恶性肿瘤患者的临床资料进行对比分析。结果:血栓组与对照组比较,脂肪肝(χ2=5.056,P=0.025)、术后化疗(χ2=13.657,P<0.001)及围手术期给予止血药物(χ2=12.007,P=0.001)明显增加VTE的发生率,而术中化疗(χ2=8.233,P=0.004)及术后采用抗凝等预防措施(χ2=18.582,P<0.001)则显著降低VTE的发生率。而其余因素两组间无统计学差异。Logistic回归分析提示围手术期给予止血药物与术后VTE的关系最密切,OR为6.129(1.242,30.239)。VTE使得患者住院时间明显延长(P=0.010)。结论:妇科恶性肿瘤患者术后发生VTE的可能性大,术前应进行危险因素评估,对于合并高血压、糖尿病、高血脂、脂肪肝、术后化疗以及围手术期接受止血药物治疗的患者,应采取积极的多种联合预防措施,以减少术后VTE的发生。     

妇科良性疾病腹腔镜术后中重度疼痛相关影响因素分析

Objective?To investigate the occurrence and influencing factors of moderate and severe pain after laparoscopic surgery for benign gynecological lesions. Methods?A total of 114 gynecological patients undergoing laparoscopic hysterectomy and adnexectomy in Peking University People's Hospital from April 2021 to July 2021 were prospectively selected as the study subjects, and 100 patients with benign gynecological diseases were included in the analysis. According to the degree of postoperative pain, they were divided into moderate and severe pain group (63 cases) and mild pain group (37 cases). According to the number of organs involved in the operation, the patients were divided into three groups: single organ operation (45 cases), double organ operation (30 cases), three or more organs operation (25 cases). Height, body mass, body mass index (BMI), preoperative pain degree, operation type, operation time and analgesic drug dosage were compared between mild pain group and moderate and severe pain group 72 h after operation. Univariate and logistic multifactor regression were used to analyze the risk factors of postoperative pain. Results?The incidence of postoperative pain in multiple organ surgery (80.00%, 20/25) was higher than that in single organ surgery (51.11%, 23/45) and double organ surgery (66.67%, 20/30), and the difference was statistically significant (P＜0.05). Logistic multivariate regression analysis showed that multiple organ surgery (OR=7.541, 95%CI: 2.035-27.952, P=0.0025) and analgesic drug dosage (OR=1.097, 95%CI: 1.009-1.193, P=0.0303) were risk factors for postoperative pain (P<0.05). Postoperative pain significantly affected the activity and sleep of patients (P<0.05). Conclusion?The incidence of postoperative pain in gynecological laparoscopic multi-organ surgery is high, and the pain significantly affects postoperative activity and sleep of patients. Pain management should be carried out according to different surgical types.     

妇科良性疾病腹腔镜术后中重度疼痛相关影响因素分析

目的 探讨妇科良性疾病腹腔镜手术后中重度疼痛发生情况及影响因素。方法 前瞻性选取2021年4月至2021年7月北京大学人民医院114例因妇科良性疾病行腹腔镜下子宫、附件切除术患者作为研究对象,其中100例患者符合标准纳入分析。按照术后疼痛程度分为中重度疼痛组（63例）,轻度疼痛组（37例）;并按手术涉及脏器数分为三组：单脏器手术（45例）、双脏器手术（30例）、3个及以上脏器手术（25例）。进行术后问卷调查,比较术后72 h轻度疼痛与中重度疼痛组患者身高、体质量、体质指数（BMI）、术前疼痛、手术类型、手术时间、麻醉镇痛用药及疼痛对患者活动及睡眠影响。采用单因素和logistic多因素回归分析术后疼痛的危险因素。结果 多脏器手术术后疼痛发生率（80.00%, 20/25）高于单脏器手术（51.11%, 23/45）及双脏器手术（66.67%, 20/30）,三组比较,差异有统计学意义（P <0.05）;而三组术前疼痛状态、BMI分级、手术时间比较差异无统计学意义（P>0.05）。logistic多因素回归分析显示,多脏器手术（OR=7.541, 95%CI:2.035～27...     

产后抑郁的临床特征及相关心理社会因素分析

目的探讨产后抑郁的临床特征及相关心理社会因素分析，建立相应的随访医疗措施，预防和减少产后抑郁的发生。方法回顾分析31例产后抑郁患者的临床特征并与非产后抑郁患者进行心理社会因素比较分析。结果夫妻关系不佳、家庭及社会支持性差、家庭态度不良均为产后抑郁的高危因素。结论产后是一个心理敏感时期，应尽量加强产妇的心理保健，以减少产后抑郁的发生。     

化疗后糖尿病发病相关因素的分析

目的　探讨化疗对妇科恶性肿瘤患者糖尿病发生的影响。方法　采用回顾性分析方法对我院 5年来初治的妇科恶性肿瘤患者 2 5 6例及 16 0例同期因妇科良性肿瘤住院手术患者进行了随访 ,对其糖尿病发病因素进行总结分析。结果　化疗后糖尿病与合并心血管疾病、电解质紊乱、化疗及绝经相关 ;妇科恶性肿瘤术后化疗与单纯手术患者相比前者糖尿病发生显著增加 (P <0 0 0 1) ,以卵巢恶性肿瘤为主 ,随着化疗疗程增加患糖尿病人数逐渐增加。不同的化疗方案对糖尿病发生的影响也有差别 ,糖尿病发生与手术范围关系不大。结论　化疗可能诱发糖尿病 ,应引起重视。     

流浪精神病患者住院情况的相关因素分析及护理

目的:通过对流浪精神病患者住院情况的分析,探讨相应的护理措施。方法:对有救助站送入本医院的52例流浪精神病患者进行分析。结果:治疗2周末简明精神病量表(BPRS)因子与治疗前无差异(P>0.05),治疗4周BPRS各因子有显著性差异(P<0.05)。在治疗2周末护士用住院病人观察量表(NOSIE)中社会功能,激惹,抑郁,总消极因子分较治疗前有显著性变化(P<0.05),其余各因子治疗前后无变化,4周末治疗前后均有显著性差异(P<0.05)。结论:流浪精神病患者是一特殊群体,他们病种多,病情重,诊断和治疗困难。并以缄默不语,行为退缩等阴性症状为主,并伴有躯体疾病且以外省农村的居多,影响市容市貌。呼吁全社会给于关注并采取综合监管措施,促进患者的康复,有利于社会的和谐发展。     

基于EQ-5D量表评估妇科恶性肿瘤患者生命质量及其相关因素分析

目的 研究妇科恶性肿瘤患者生命质量的现况及其影响因素,通过构建其专属的健康效应积分体系,探究这类人群的健康偏好。方法 收集2019年8月至2020年1月在上海交通大学医学院附属仁济医院妇科住院诊断为恶性肿瘤的99例患者为研究对象。采取面谈方式完成调查欧洲五维健康量表（EQ-5D量表）。通过统计学分析其生命质量的影响因素,构建妇科恶性肿瘤患者专属健康效应积分体系,评价其与普通人群健康偏好的差异。结果 EQ-5D量表分析发现,是否处于随访期、是否为Ⅳ期/复发组患者是影响妇科恶性肿瘤患者生命质量的主要因素。新构建的EQ-5D-5L量表专属健康效应积分体系分析发现,同一个健康状态,妇科恶性肿瘤患者的健康偏好较普通人群倾向于认为其“更加可以接受”。结论 EQ-5D量表适合妇科恶性肿瘤患者生命质量的评估;新构建的专属健康效应积分体系分析发现,她们对于有问题的健康状态接受度更高,这类患者的疼痛、心理健康应被充分重视。     

子宫颈癌Ⅰb和Ⅱa期患者预后相关因素的分析

宫颈癌是最常见的妇科恶性肿瘤，占女性恶肿瘤发病率的第2位。流行病学调查结果显示，山西省是国内的宫颈癌高发区；是我国窃听器颈癌病死率最高的3个省份之一。     

Ongoing or previous mental disorders predispose to adverse mood reporting during combined oral contraceptive use

Purpose: Previous studies have emphasised that women with pre-existing mood disorders are more inclined to discontinue hormonal contraceptive use. However, few studies have examined the effects of combined oral contraceptives (COC) on mood in women with previous or ongoing mental disorders.

Materials and methods: This is a supplementary analysis of an investigator-initiated, double-blinded, randomised clinical trial during which 202 women were treated with either a COC (1.5?mg estradiol and 2.5?mg nomegestrolacetate) or placebo during three treatment cycles. The Mini International Neuropsychiatric Interview was used to collect information on previous or ongoing mental disorders. The primary outcome measure was the total change score in five mood symptoms on the Daily Record of Severity of Problems (DRSP) scale in the intermenstrual phase of the treatment cycle.

Results: Women with ongoing or previous mood, anxiety or eating disorders allocated to COC had higher total DRSP Δ-scores during the intermenstrual phase of the treatment cycle in comparison with corresponding women randomised to placebo, mean difference 1.3 (95% CI 0.3–2.3). In contrast, among women without mental health problems, no difference in total DRSP Δ-scores between COC- and placebo users was noted. Women with a risk use of alcohol who were randomised to the COC had higher total DRSP Δ-scores than women randomised to placebo, mean difference 2.1 (CI 95% 1.0–3.2).

Conclusions: Women with ongoing or previous mental disorders or risk use of alcohol have greater risk of COC-induced mood symptoms. This may be worth noting during family planning and contraceptive counselling.     

The contribution of spirituality and spiritual coping to anxiety and depression in women with a recent diagnosis of gynecological cancer

The objective of this study was to determine whether, after accounting for illness and demographic variables, spiritual involvement and beliefs and positive and negative spiritual coping could account for any of the variation in anxiety and depression among women within 1 year's diagnosis of gynecological cancer (GC). One hundred patients from outpatient GC clinics at two Melbourne-based hospitals completed a brief structured interview and self-report measures of anxiety, depression, spirituality, and spiritual coping. Using two sequential regression analyses, we found that younger women with more advanced disease, who used more negative spiritual coping, had a greater tendency towards depression and that the use of negative spiritual coping was associated with greater anxiety scores. Although not statistically significant, patients with lower levels of generalized spirituality also tended to be more depressed. The site of disease and phase of treatment were not predictive of either anxiety or depression. We conclude that spirituality and spiritual coping are important to women with GC and that health professionals in the area should consider these issues.     

妇科恶性肿瘤合并自身免疫性疾病38例临床分析

目的 探讨妇科恶性肿瘤合并自身免疫性疾病的临床病理特点、治疗及预后.方法 采用回顾性分析方法对2004年6月至2019年9月在北京大学人民医院妇科住院治疗的妇科恶性肿瘤合并类风湿关节炎(RA)、系统性红斑狼疮(SLE)、皮肌炎(DM)、银屑病(psoriasis)38例患者进行分析.结果 38例妇科肿瘤患者中,宫颈癌 ...     

Pre-existing mental health disorders and pregnancy

Mental health conditions are independent risk factors for poor obstetric and neonatal outcomes therefore obstetricians need to be able to manage them well. This review will summarize the management of pre-existing mental health disorders in pregnancy. Explanations will be given as to which women are managed in primary care for their mental health conditions and which women are managed in specialist Perinatal Mental Health Services. When women should be referred to perinatal mental health services is described. The article provides recommendations on the obstetric management of these women as well as information on psychotropic medication in pregnancy and lactation.     

Pathologies observed in barium enema examination in patients with gynecological disorders

The aim of our study was to analyse retrospectively 171 patients with gynaecological diseases, who have undergone barium enema examination in Third Teaching Hospital in Poznań between 1992 and 1998. 79 patients were diagnosed with ovarian tumours, in 24 cases their colon was dislocated. Stenosis was detected in 20 women and in five situations inflammatory changes of the colon were present. Malignant infiltration of large intestine was suspected in ten patients. The second group included 24 women diagnosed with tubo-ovarian abscesses and adnexitis. Three of them had dislocated colons. Stenosis of large bowel was detected in 11 patients and inflammatory changes in 8. In the next group of 35 patients' myoma uteri, myometrial endometriosis and carcinoma of colli uteri were detected. Barium enema examination revealed that 10 women had dislocated colons. In the third group stenosis was detected in eight cases, two patients had radiological signs of cancer infiltration and twice inflammatory changes of the large bowel were present. Frequency of radiological changes in barium enema examination was evaluated in the aforementioned groups. Results were compared with group of 33 patients treated for endocrinological disorders, sterility and minor pelvis pain syndrome. Frequency of dislocation of colon was compared with size of changes of ovaries measured during ultrasound examination. Our results showed that barium enema is still an important supplementary examination, which can give a great deal of beneficial information concerning the clinical condition of the patient. This procedure is useful before surgical intervention especially in cases of suspected ovarian cancer. We must underline that the same or similar information can be obtained using other methods without such radiation exposure.     

护理干预或者人文关怀对围绝经期妇女焦虑抑郁状态的影响研究

目的:探讨围绝经期妇女抑郁、焦虑状态相关因素及综合护理干预的影响。方法:选取在我院妇科就诊的40～60岁之间的522名妇女进行问卷调查,调查工具选择抑郁自评量表(SDS)及焦虑自评量表(SAS)。对有抑郁、焦虑症的妇女给予综合护理干预,4周后再次进行SDS、SAS评定,比较干预前后评分的差异。结果:522名妇女中抑郁、焦虑的发生率分别为9.39%、7.66%;夫妻关系差、性欲下降及合并躯体疾病者抑郁、焦虑的发生率高(P<0.01或P<0.05);对抑郁、焦虑症妇女给予综合护理干预后,其抑郁、焦虑评分均有显著好转(P<0.01)。结论:围绝经期妇女中抑郁、焦虑症的发生率比较高,除生理因素外,夫妻关系、性生活情况及躯体疾病等均是其相关影响因素。辅以综合护理干预,可以缓解其抑郁、焦虑程度。     

Psychological assessment of patients with premature ovarian failure

Objective.?The objective of the present work was to perform an overall psychological assessment of patients diagnosed with premature ovarian failure, with the aim of studying personality traits and assessing anxiety, depression and psychosocial stress among women suffering from this physical condition.

Methods.?We surveyed 21 patients between 18 and 39 years old. We psychologically assessed the patients with the following techniques: semi-structured interview, Beck Depression Inventory, State-Trait Anxiety Inventory for Adults, Millon Index of Personality Styles, Psychosocial Stress Severity Scale, Human Figure Drawing Test, Two Person Drawing Test, and Rorschach Inkblot Test. The Pearson moment correlation statistic was utilized to appreciate correlation between the variables. To compare the results obtained we used the χ² test, the Kolmogorov–Smirnov test and Student's t test. Significance level was set at α = 0.05.

Results.?We found that these patients did not show high levels of depression, but they did show high values of anxiety. Psychosocial stress was higher throughout the year before they lost their menstrual cycles, than during the year before the psychological evaluation. Regarding personality profiles, the following scales stood out from the rest: Actively Modifying, Self-Indulging, Internally Focused, Realistic/Sensing, Feeling-Guided, Dominant/Controlling and Dissatisfied/Complaining.