稽留流产妇女情绪障碍情况及心理疏导对其调控作用

目的研究稽留流产妇女情绪障碍情况及心理疏导对其调控作用。方法选择本院因稽留流产需要终止妊娠的妇女987名，为疏导组495例，非疏导组492例，早期计划人工流产妇女500例（为流产组），非疏导组和流产组不进行心理疏导。采用宗氏抑郁自评量表（SDS）和焦虑自评量表（SAS）对3组患者分别用自填问卷的方式进行调查。结果抑郁障碍得分和发生比例，疏导组、非疏导组和流产组术前分别为（60．2±3．3）、（59．8±5．2）和（52．2±4．1）分，62．7％、63．4％和56．0％；术后分分别为（56．4±2．1）、（68．7±2．0）和（54．2±1．4）分，55．6％、69．5％和58．4％；焦虑障碍得分和发生比例，疏导组、非疏导组和流产组术前分别为（59．4±6．7）、（58．7±4．5）和（48．2±6．3），38．4％、38．2％和32．0％；术后分别为（58．2±2．1）、（65．9±2．0）和（50．3±1．4）分，31．9％、49．4％和34．6％；术前抑郁和焦虑障碍得分及发生比例，疏导组与非疏导组比较，差异均无统计学意义；疏导组和非疏导组高于流产组，差异均有统计学意义；术后抑郁和焦虑障碍得分和发生比例，疏导组低于本组术前、非疏导组和流产组高于术前；非疏导组高于疏导组和流产组，差异有统计学意义；非疏导组术后焦虑性比例高于术前，差异有统计学意义。结论稽留流产患者的心理障碍发生情况比早期人工流产患者严重，但经过心理疏导，能够明显减少稽留流产患者情绪障碍发生情况。

Emotioval disorders and psychological counseling for patients with missed abortion

Objective To characterize the emotional disorders of and to examine the effect of psychological coun- seling for women with missed abortion. Methods A total of 987 women who came to seek termination of pregnancy due to missed abortion were randomly divided into two groups, the psychological counseling group with 495 cases and the no counseling group with 492 cases. Additional 500 women who came to seek early non-medical abortion were served as the control group. Zung Shi Self-Rating Depression Scale （SDS） and anxiety self-assessment scale （SAS） were administered to each patient. Results The SDS standard scores before operation in the counseling, non-counseling group, and the con- trol group were （ 60. 2 ± 3.3 ） , （ 59. 8 _± 5.2） , and （ 52. 2 ± 4. 1 ）, respectively. The incidence of depre,±sive disorders in the counseling group before operation was 62.7 % as compared with 63.4 % in the non-counseling group and 56.0 % in the control group. The SDS standard scores after operation in the counseling, non-counseling, and control groups were （56. 4 ±2. 1 ）, （68.7 ±2. 0）, and （54. 2 ± 1.4）, respectively. The incidence of depressive disorder after operation in the counseling group was 55.6 %, which was lower than that of the non-counseling group （ 69. 5 % ）, and lcwer than that be- fore operation （58.4 % ）. Depressive disorder incidence of non-counseling after operation was 69.5 %, which was higher than that before surgery （63.4 % ）. The SAS standard scores before operation in the counseling, non-colmseling, and the control group were （ 59.4 ± 6. 7 ）, （ 58. 7 ± 4. 5 ）, and （48.2 ± 6. 3 ）, respectively. The incidence of anxiety disorders before operation in the counseling group was 38.4 % as compared with 38. 2 % in the con-counseling group, and 32. 0 % in the control group. The SAS standard scores after operation in the counseling, non-counseling, and the control gIoup were（58.3 ± 2. 1 ）, （65.9 ±2.0）, and（50. 3 ± 1.4）, respectively. The incidence of anxiety disorders in the counselling group before operation was 31.9 %, which was lower than that in the con-counseling group （49.4 % ）, and lower tharL that before oper- ation （38.4 % ）. Anxiety disorder incidence in non-counseling group after operation was 49.4 %, which was higher than that before surgery （38. 2 % ）. Conclusion Mental disorders were more common in patients with missed abortion than in patients seeking early abortion. Psychological counseling can significantly reduce the occurrence of emolional disorders in patients with missed abortion.