地屈孕酮联合心理干预对复发性流产患者妊娠结局影响研究.docVIP

地屈孕酮联合心理干预对复发性流产患者妊娠结局影响研究 　　doi：10.3969/j.issn.1007-614x.2014.15.52 　　摘 要 目的：了解地屈孕酮联合心理干预对复发性流产患者妊娠结局的影响。方法：将157例患者随机分为心理干预组79例和对照组78例。心理干预组采用口服地屈孕酮及心理健康疏导，对照组采用口服地屈孕酮及常规指导，观察治疗前后SAS、SDS评分以及妊娠结局。结果：在口服地屈孕酮后通过心理疏导解除患者焦虑、抑郁心理，心理干预组的SAS、SDS评分组明显低于治疗前及对照组的评分，其最终妊娠结局也有明显改善。结论：反复流产对患者在心理上造成很明显焦虑及恐惧，通过药物及心理疏导可以提高复发性流产患者的妊娠结局。 　　关键词 地屈孕酮 复发性流产 心理干预 　　Dydrogesterone combined with psychological intervention on research of recurrent spontaneous abortion pregnancy outcome influence 　　Zhu Li，Liu Qin，Liu Yufang，Xi Yufan 　　The First Maternal and Child Health Hospital of Huizhou City，Guangdong 516007 　　Abstract Objective：Understanding of dydrogesterone combined with psychological intervention on influence of recurrent spontaneous abortion pregnancy outcome.Method：157 patients were randomly divided into the psychological intervention group with 79 cases and the control group with 78 cases.The psychological intervention group used dydrogesterone orally and mental health counseling.The control group used dydrogesterone orally and conventional guidance.We observed the score of SAS and SDS before and after treatment and the pregnancy outcome.Results：We relieved the anxiety and depression of the patients by psychological counseling after they had progesterone.The score of the group of psychological intervention group was obviously lower than the control group before treatment，and its final pregnancy outcomes have improved significantly.Conclusion：Recurrent abortion can cause obvious anxiety of the patients and fear psychological，and we can improve the outcome of pregnancy in women with recurrent spontaneous abortion by the drug and psychological counseling. 　　Key words Dydrogesterone；Recurrent abortion；Psychological intervention 　　复发性流产（RSA）是指与同一性伴侣连续遭受≥2次妊娠在20周前的胎儿丢失者[1]，是育龄妇女的常见病，发病率约1%～5%[2]。目前治疗结局不甚理想[3]。反复的流产不但增加患者的经济负担，更增加其心理负担，可产生不同程度的紧张、焦虑、抑郁、恐惧等心理变化。笔者对这类患者积极安胎治疗，同时根据患者的个体化心理问题，针对性地辅以心理指导，减轻患者的心理负担，进一步改善妊娠结局。 　　资料与方法 　　2012年7月-2013年7月收治早期复发性流产患者157例，随机分为心理干预组79例和对照组