排卵障碍性不孕症患者心理状况及心理干预研究

目的探讨心理干预对排卵障碍性不孕症患者的心理状况及妊娠结局的影响。方法将232例排卵障碍性不孕症患者随机分为实验组和对照组，每组116例，对照组仅接受常规药物促排卵治疗，实验组在常规药物治疗基础上增加心理干预。两组患者均接受艾森克个性问卷（EPQ）、90项症状自评量表（SCL-90）及社会支持评定量表（SSRS）问卷调查，分析两组患者治疗前后的心理健康状况及临床疗效。结果排卵障碍性不孕症患者的心理状况较差；经心理干预后患者的心理健康状态得到改善，EPQ测评中的内、外向及神经质因子改善差异显著（P〈o．01），SCL-90测评中的强迫、人际关系敏感、抑郁、焦虑、敌对、偏执因子，以及ssRs测评中的主观支持和支持利用度明显改善（P（0．05）。治疗后，两组患者月经周期第3天促黄体生成素（LH）、卵泡刺激素（FsH）、催乳素（PRL）、睾酮（T）及雌二醇（E2）水平变化差异显著（P（0．01）；两组患者子宫内膜厚度、形态变化差异有统计学意义（P（0．05），实验组总优势卵泡率、排卵率及临床妊娠率明显优于对照组（分别为64．58％VS．49．07％，56．11％VS．42．55％，43．97％VS．25．86％）（P〈0．01）。结论排卵障碍性不孕症患者存在不同程度的心理健康问题；系统的心理干预能够改善患者的心理健康状况，提高临床妊娠率。

Study on the psychological condition and interventions among the patients with anovulatory infertility

Objective： To explore pregnancy outcome of the pat Methods： A total of 232 the effect of psychological intervention on psychological condition and ients with anovulatory infertility. patients with anovulatory infertility were randomly divided into experimental group and control group,ll6 patients for each group. The patients in control group were only treated with conventional drugs to stimulate ovulation. The patients in experimental group were treated with routine drugs to stimulate ovulation plus psychological intervention. All the patients were tested by the Eysenck Personality Questionnaire（EPQ）, 90 symptoms self evaluation scale （SCL-90）, and social support rating scale（SSRS） questionnaire. The mental health status of patients before and after treatment and clinical curative effect were analyzed. ResuLts： The psychological condition of the patient with ovulation disorder was poor. After psychological intervention, mental health status of the patients was improved. The inside and outside neuroticism factors in EPQ evaluation were significantly improved （P 〈0.01 ）. The forcing, interpersonal sensitivity, depression,anxiety hostile, paranoid factor in SCL-90 evaluation and the subjective support andsupport utilization degree in SSRS evaluation were significantly improved（P〈0.05）. After intervention, the levels of luteinizing hormone （LH）, follicle stimulating hormone （FSH）, prolactin（PRL）, testosterone （T） and estradiol （E2） on the 3rd day of menstrual cycle were significantly different in the patients of two groups（P〈0.01）. The endometrial thickness, morphology difference were also significantly different in the patients of two groups （P 〈 0, 05）. The total dominant follicle rate （64.585 vs. 49.07%）, ovulation rate （56.11
% vs 42.55%）, and clinical pregnancy rate （43.97% vs. 25.86%）in the patients of experimental group were significantly higher than those in control group （P〈0.01）. Conclusions： The patients with anovulatory infertility have different degrees of problems in psychological health condition. The systematic psychological intervention can improve mental health status of the patients and raise clinical pregnancy rate.