认知行为疗法对宫腔内夫精人工授精患者临床妊娠结局及心理状态的影响

目的 探讨认知行为疗法对宫腔内夫精人工授精(intrauterine insemination,IUI)患者临床妊娠结局及心理状态的影响.方法 选取2017年10月至2019年6月在陆军第七十三集团军医院生殖医学中心接受IUI治疗的156例患者为研究对象.按照随机数字表法分为观察组与对照组,每组各78例.两组患者均采用...

Effect of cognitive behavioral therapy on the clinical pregnancy outcome and mental state of patients with intrauterine insemination

Objective To explore the effect of cognitive behavioral therapy on clinical pregnancy outcome and psychological state of patients with intrauterine insemination(IUI).Methods 156 patients who received IUI treatment in the Reproductive Medicine Center of Military Hospital of the 73rd Army Group from October 2017 to June 2019 were selected as the research objects.According to the random number table,they were divided into observation group and control group,with 78 cases in each group.Both groups were treated with standardized routine nursing measures,and the observation group was treated with cognitive behavioral therapy in additoon.All patients filled in the symptom checklist 90(SCL-90)at admission and at the end of the first cycle.The psychological status,clinical pregnancy rate and the proportion of giving up treatment in each cycle were compared between the two groups.Chi-square,Fisher exact probability method and t-test were used for statistical analysis.Results There was no significant difference between the two groups in age,infertility years,education level,infertility composition,ovulation induction scheme or infertility causes(P>0.05).There were 402 IUI cycles in 156 patients,including 34 clinical pregnancies.The clinical pregnancy rate was 21.8%and the cycle pregnancy rate was 8.5%.The clinical pregnancy rates of the observation group and the control group were 25.6%(20/78)and 18.0%(14/78),respectively,but there was no significant difference(χ²=1.354,P=0.245).In each cycle,there was no significant difference in the clinical pregnancy rate between the control group and the observation group(P>0.05).In the second cycle,the abandonment rate of the control group was 7.1%(5/70),and there were no abandonment cases in the observation group(P=0.028).In the third cycle,the abandonment rate of the control group was higher than that of the observation group21.3%(13/61)vs 3.1%(2/64),χ²=8.136,P=0.004].At the end of the first cycle of IUI,the SCL-90 scores of the 9 factors in the control group were lower than those at admission,while the scores of 10 factors in the observation group were lower than those at admission.There was no significant difference in SCL-90 self-assessment scores between the two groups at admission(P>0.05).At the end of the first cycle of IUI,the scores of somatization(2.1±1.0 vs 1.7±0.7),compulsion(1.9±0.9 vs 1.6±0.8),interpersonal relationship(2.4±0.9 vs 1.9±0.9),depression(2.6±1.0 vs 2.2±1.1),anxiety(2.2±1.0 vs 1.7±0.8)and hostility(2.0±1.0 vs 1.7±0.8)in the control group were significantly higher than those in the observation group(P<0.05).Conclusion Cognitive behavioral therapy can effectively promote communication between nurses and patients,improve the adverse psychological state of patients with IUI,and reduce the number of cases of giving up treatment,which can be applied in clinical practice.