全子宫切除术患者围手术期术前心理干预

目的探讨腹腔镜下子宫全切患者术前的心理体验和经历。方法根据半结构访谈的原则和方法对12名腹腔镜下子宫全切患者进行访谈,并用Colaiazzi方法进行资料的分析。结果腹腔镜下子宫全切患者的心理体验主要有:震惊和逃避,寻找证据,接受现实,对手术的担心,对术后的担心这几个体验,并且渴望周围人的关心。结论术前心理管理应根据腹腔镜下子宫全切患者心理体验,呈阶段性变化特点,同时不同的疾病心理体验阶段性变化不太一样,医护人员可根据这些阶段性变化特点,采取预见性的干预,将工作前移,减少患者痛苦的时间,减轻负性心理体验,避免不良情绪给患者带来的影响。     

子宫切除患者术前术后心理问题干预的调查研究

目的:探讨心理干预对子宫切除患者的影响。方法:采用汉密尔顿焦虑量表(HAMA14项量表)对患者进行评定。观察患者刚住院时、手术后5天的抑郁焦虑情况,评定心理干预在改善抑郁焦虑症状中的作用。结果:经过心理干预,病人的心理焦虑有明显改善。结论:及时心理干预可解除患者存在的心理问题。     

绝经前子宫切除与自然绝经妇女骨代谢生化指标的临床观察

目的:观察绝经前子宫切除和自然绝经妇女骨代谢生化指标的变化。方法:对比观察绝经前行子宫切除妇女38例、自然绝经后妇女40例及生育期健康妇女40例的骨代谢血尿生化指标的变化。结果:绝经前子宫切除组和自然绝经组的尿钙、尿脱氧吡啶、血硷性磷酸酶、骨钙素明显高于生育期健康组(P<0.05);自然绝经组的尿钙、尿脱氧吡啶、血骨钙素高于绝经前子宫切除组(P<0.05),血硷性磷酸酶在两组差异无统计学意义(P>0.05)。结论:绝经前子宫切除和自然绝经后妇女骨生成和骨吸收均增加,自然绝经妇女骨转换率进一步升高。     

伊犁少数民族妇女腹腔镜筋膜内子宫切除与开腹子宫切除120例临床分析

目的探讨伊犁州少数民族妇女腹腔镜筋膜内子宫切除术（CISH）的临床疗效。方法回顾分析该院少数民族妇女CISH 63例与开腹子宫切除57的例临床资料。结果腹腔镜手术时间63～92 min,平均（75.3±16.3）min,略长于开腹手术,差异有统计学意义（P〈0.05）;术中出血30～50 ml,平均36.5±17.4 ml,术后排气时间24～36 h,平均（30.3±4.5）h,术后住院天数平均（4.2±1.4）d,与开腹手术比较,差异有统计学意义（P〈0.05）;而术后最高体温2组相比较,差异无统计学意义（P〉0.05）。结论 CISH具有术中出血少、术后恢复快、住院时间短等优点。     

经阴道与经腹子宫切除术临床效果对比分析

目的评价经阴道与经腹子宫切除术在子宫良性病变中的临床效果。方法对2006年5月—2008年6月因子宫良性病变需行子宫切除术的121例病例进行回顾性分析,其中经阴道子宫切除术58例（阴式组）,经腹子宫切除术63例（开腹组）。主要对比2组手术时间、术中出血量、术后住院时间、术后排气时间、术后镇痛药使用率、术后病率、术后并发症等。结果2组手术时间,术中出血量比较差异无统计学意义（P〉0．05）;阴式组术后排气早、住院时间短、术后镇痛药使用率及术后病率低与开腹组比较差异有统计学意义（P〈0．05）。结论经阴道子宫切除术较经腹子宫切除术具有创伤小,恢复快的优点,符合微创观点。     

The Effects of Hysterectomy on Sexual Arousal in Women with a History of Benign Uterine Fibroids

Research indicates hysterectomy surgery may adversely affect the pelvic autonomic nerves and autonomic mechanisms are integral to the sexual arousal response in women. This study explored the possibility that women who undergo hysterectomy may experience an impaired vasocongestive response to erotic stimulation. Thirty-two women with a history of benign uterine fibroids who had ( n = 15) or had not ( n = 17) undergone hysterectomy participated in two experimental sessions in which self-report and physiological (vaginal pulse amplitude; VPA) sexual responses were recorded during an erotic film presentation. In one of the sessions, the women exercised on a treadmill for 20 min prior to viewing the erotic films as a means inducing autonomic arousal. Exercise significantly increased VPA but not subjective sexual responses in both groups of women. VPA responses were marginally higher among the fibroid than hysterectomy group in the no-exercise condition. The hypothesis that physiological sexual arousal may be impaired with hysterectomy surgery was only partially supported.     

腹腔镜辅助阴式全子宫切除与开腹全子宫切除的临床对比

目的:研究腹腔镜辅助阴式全子宫切除与开腹全子宫切除的临床疗效。方法:取本院子宫肌瘤患者104例为研究对象,随机分观察组(腹腔镜辅助阴式全子宫切除术)与对照组(开腹全子宫切除术)各52例,比较手术指标与并发症。结果:与对照组比较,观察组出血量少,手术时间、肛门排气与住院时间均较短,观察组并发症率(3.84%)较对照组(15.38%)低,P<0.05(具统计学差异)。结论:与开腹全子宫切除比较,对子宫肌瘤患者采用腹腔镜辅助阴式子宫切除术治疗能缩短手术、肛门排气与住院时间,减少出血量与并发症。     

心理干预对减轻孕产妇分娩疼痛作用观察

目的探讨心理干预对减轻孕产妇分娩疼痛的作用。方法将1386例无合并症的足月孕产妇随机分为对照组（697例）和干预组（689例）,在分娩前后对照组采取产科常规技术操作,干预组在此基础上进行全程的心理干预。结果干预组孕产妇分娩疼痛发生率及程度明显低于对照组（P〈0．01）。结论心理干预可以减轻孕产妇分娩疼痛,降低剖宫产率,促进自然分娩,提高产科质量。     

阴式子宫切除术与腹腔镜辅助阴式子宫切除术的术式比较

目的探讨阴式子宫切除术(TVH)和腹腔镜辅助阴式子宫切除术(LAVH)的临床效果及应用价值。方法回顾性分析2007年1月至2010年12月在本院行TVH的86例患者(TVH组)与同期行LAVH的92例患者(LAVH组)的临床资料,对两组患者术中、术后情况进行统计学分析(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并与其签署临床研究知情同意书)。两组患者既往盆腔手术史、孕次、产次、合并贫血及子宫增大(相应孕周)情况比较,差异无统计学意义(P>0.05)。结果 TVH组患者手术时间、术中出血量及手术费用均较LAVH组短、少和低,两组比较,差异有统计学意义(P<0.05);但术后排气时间、术后病率及住院时间比较,差异无统计学意义(P>0.05)。所有患者无一例中转开腹及脏器损伤或大出血等严重并发症发生,均无发热、肠粘连、肠梗阻和术后血栓性静脉炎等手术相关并发症。结论 TVH较LAVH具有手术时间短、术中出血量少、费用低廉等优势,但TVH更适应于子宫大小<孕4个月、盆腔无明显粘连患者。LAVH可扩大TVH的适应证。临床应根据个体情况选择合适的子宫切除方式,以达到最佳治疗效果。     

非脱垂大型子宫阴式子宫切除术与腹式子宫切除术的研究对比

目的：研究对比非脱垂大型子宫阴式子宫切除术与腹式子宫切除术的效果。方法：随机选取200例非脱垂大型子宫患者,分为观察组与对照组,每组100例,分别行阴式和腹式手术治疗,对两组患者的手术基本情况以及术后镇痛药使用率和并发症发生率分别进行比较。结果：观察组手术出血量明显更少,且手术时间、术后排气时间、下床时间以及住院时间均明显要短;观察组术后并发症发生率为2.0%,术后使用镇痛药比率为20.0%;而对照组并发症发生率为8.0%,使用镇痛药比率为76.0%;观察组整体手术效果更显著,差异有统计学意义（P〈0.05）。结论：非脱垂大型子宫采用阴式子宫切除术效果显著,值得临床继续推广应用。     

阴式子宫切除术和腹腔镜辅助阴式子宫切除术比较

目的通过100例阴式子宫切除术（VH）、腹腔镜辅助阴式子宫切除术（LAVH）的比较,对比其优缺点。方法选用我院2003年1月-2008年3月符合VH和LAVH手术指征的患者进行手术,其中VH50例,LAVH50例予以对比分析。结果 VH与LAVH结果相同,明显比开腹全子宫切除术为优。LAVH手术适应证明显超过VH。结论 LAVH和VH和传统全子宫切除术比较,可减少手术创伤,避免剖腹,有明显优越之处。     

Social Support,Marital Adjustment,and Psychological Distress Among Women With Primary Infertility in Pakistan

This study aimed to identify prevalence rates of psychological distress among Pakistani women seeking help for primary infertility. The associations of social support, marital adjustment, and sociodemographic factors with psychological distress were also examined. A total of 177 women with primary infertility were interviewed from one hospital in Islamabad using a Self-Reporting Questionnaire, the Multidimensional Scale of Perceived Social Support, and the Locke-Wallace Marital Adjustment Test. The data were collected between November 2012 and March 2013. The prevalence of psychological distress was 37.3 percent. The results of the logistic regression suggested that marital adjustment and social support were significantly negatively associated with psychological distress in this sample. These associations were not confounded by any of the demographic variables controlled in the multivariable regression models. The role of perceived social support and adjustment in marriage among women experiencing primary infertility are important factors in understanding their psychological distress. The results of this small-scale effort highlight the need for social and familial awareness to help tackle the psychological distress related to infertility. Future research needs to focus on the way the experience of infertility is conditioned by social structural realities. New ways need to be developed to better take into account the process and nature of the infertility experience.     

腹腔镜辅助阴式子宫切除术与阴式全子宫切除术的疗效比较

目的：分析腹腔镜辅助阴式子宫切除术（LAVH）与阴式全子宫切除术（TVH）的手术效果。方法：回顾性分析2010年5月-2011年7月在本院进行子宫切除的110例患者,按其术式分为LAVH组55例及TVH组55例,分析比较两组患者的术中出血量、手术时间、术后体温恢复时间、肛门排气时间、住院时间、住院费用及并发症发生率。结果：LAVH组的术中出血量、手术时间、术后体温恢复时间及术后并发症发生率都少于TVH组（P〈0.05）。LAVH组与TVH组的肛门排气时间及住院时间比较差异无统计学意义（P〉0.05）。LAVH组的住院费用因术中使用全麻,高于TVH组（P〈0.05）。结论：腹腔镜辅助阴式子宫切除术（LAVH）与阴式全子宫切除术（TVH）皆属微创手术,前者费用较高,但手术效果比后者好。     

The Psychosocial Dimensions of Hysterectomy: Private Places and the Inner Spaces of Women at Midlife

Although the literature on hysterectomy is well represented by the medical and nursing professions, there is a paucity of social work research on the psychosocial dimensions of hysterectomy and surgical menopause. With over one-half million women undergoing the surgical removal of their reproductive organs each year, clinical social workers need to be aware of the potential effects of hysterectomy on the physical, affective, social, spiritual, and sexual domains of women's lives. The sequelae of a hysterectomy portend consequences for the quality of a woman's life. Using qualitative and quantitative research methods, a Web-based questionnaire was used to examine women's lived experiences of hysterectomy in each of these domains. The findings of this exploratory study (n = 74) suggest that younger women may be at greater risk for depression than older women following hysterectomy and that physician gender may influence pre-surgery decision making.     

Relationship Violence and Psychological Distress Among Low-income Urban Women

In this paper, we examined the association between relationship violence and psychological distress among low-income urban women. Extending prior research, we considered the effects of relationship violence within the context of other chronic stressors that are common in the lives of these women. Using data from the Welfare, Children, and Families project (1999), a probability sample of 2,402 low-income women with children living in low-income neighborhoods in Boston, Chicago, and San Antonio, we predicted psychological distress with multiple measures of relationship violence, a wide range of sociodemographic variables, and several chronic stressors. Our results show that relationship violence is associated with higher levels of economic hardship, neighborhood disorder, and household disrepair. We also find that relationship violence is associated with higher levels of psychological distress, net of these other chronic stressors. Finally, we observe that the effects of relationship violence do not vary according to the chronic stressors under study. Because the adverse effects of relationship violence are similar for women despite other adverse circumstances, interventions and treatment efforts focused exclusively on relationship violence may make a unique contribution to the psychological well-being of low-income urban women. Hill and Mossakowski are with the Department of Sociology, University of Miami, Coral Gables, USA; Angel is with the Department of Sociology, University of Texas, Austin, TX, USA.     

Intimate Violence Among Women of Mexican Origin: Correlates of Abuse

Data from the Mexican American Prevalence and Services Survey (Vega, Kolody, Aguilar-Gaxiola, Alderete, Catalano, & Caraveo-Anduaga, 1998) was used to test the impact of acculturation and acculturation stress on intimate partner abuse of women of Mexican origin. Findings indicated that higher acculturation increases intimate abuse, and social support reduces it. Acculturation stress increases abuse only among immigrants. Abuse rates are higher among U.S.-born Mexican Americans than immigrants. There are no additive effects of education and income in explaining abuse within a multivariate model. These results suggest a complex causal process that could not be fully addressed in this study. Our results highlight the need for improved understanding about how the acculturation and acculturation stress processes are differentially related to intimate violence among immigrants and U.S.-born Mexican Americans.     

Sensitivity and Specificity in Three Measures of Depression Among Mexican American Women

This paper examined the prevalence of depressive symptomotology among women of Mexican ancestry (N?=?205), over the age of 18, of diverse incomes and nativity. We examined differences in rates of diagnosis by Spanish/English preference and the sensitivity and specificity of three common measures: the Patient Health Questionnaire (PHQ9), the Kessler Psychological Distress Scale (K-10), and depression questions from the Composite International Diagnostic Interview, Short Form (MDD CIDI-SF); PHQ9 was used as the “gold standard” measure. Results indicated 18–32?% of participants met criteria for depression with higher rates found among Spanish preference participants. The K-10 had significantly higher sensitivity (0.81) but lower specificity (0.79) than the MDD CIDI-SF items (0.57 and 0.89, respectively). This study suggests that the K-10 and MDD CIDI-SF measures are complementary to each other for screening of depressive symptomatology. Implications for cultural and linguistic assessment of depression are further discussed.     

产褥期妇女抑郁状态及其家庭与心理学影响因素的LOGISTIC回归分析

目的:研究产褥期妇女抑郁状态的影响因素。方法:采用单因素Logistic及多因素Logistic分析,将潍坊市5家不同级别的医院作为调查点:从2003年7~11月期间在以上医院分娩的妇女用单纯随机抽样方法抽取调查对象;在产妇分娩6周内对调查对象进行访谈,获取现状资料。结果:调查的513例产褥期妇女中,抑郁发生率为8.19%。在α=0.25水准上有统计学意义的家庭与心理学因素进入多因素分析,最后筛选出"家庭年均收入""照顾类型""夫妻感情""与丈夫的家庭地位"因素对产褥期抑郁的发生有影响作用。结论:家庭年均收入越低越易于发生抑郁;照顾类型中"丈夫及其家人"组的产妇发生抑郁的概率是"丈夫及双方家人"组产妇的2.282倍;夫妻感情"较好及以下"组的产妇是"很好"组的16.918倍;与丈夫的家庭地位"不平等"组的产妇发生抑郁的危险性是"平等"组的7.901倍。