曾韩+伍琼芳+陈晶晶

[摘要]目的 評价高龄妇女实施辅助生殖技术过程中针对性地采取人文关怀护理干预措施的效果。方法 选择2016年1～4月于本中心接受体外受精-胚胎移植（IVF-ET）治疗的388例高龄不孕患者，根据建档顺序将其分为观察组200例和对照组188例，对对照组患者做好基本的临床护理工作，患者促排卵阶段、夜针日、取卵和胚胎移植前后常规健康宣教指导并对患者进行焦虑自评量表（SAS）、抑郁自评量表（SDS）评分及患者满意度问卷调查。观察组对患者建档日、启针日、夜针日、取卵日、胚胎移植日利用SAS、SDS及自制患者治疗需求问卷调查表进行测定，了解患者治疗期间的心理状态、社会需求等，针对性采取心理护理、健康教育指导，并在干预措施后再次进行SAS、SDS评分及患者满意度问卷调查。观察两组患者的周期取消率、获卵数、优质胚胎率、临床妊娠率及SAS、SDS评分、满意率调查情况。结果 两组的周期取消率、获卵数、优质胚胎率、临床妊娠率比较，差异无统计学意义（P>0.05）；干预后，观察组患者的SAS、SDS评分明显低于对照组（P<0.05）。观察组的护理满意度为96%，明显高于对照组的84%，差异有统计学意义（P<0.05）。结论 高龄患者实施辅助生殖技术过程中通过人性化心理护理干预能够有效缓解患者的心理压力，提高其治疗满意度。

[关键词]高龄妇女；辅助生殖技术；护理

[中图分类号] R473.71 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0185-04

[Abstract]Objective To evaluate the effect of humanistic nursing intervention in the process of assisting reproductive technology in elderly women.Methods From January to April in 2016，388 elderly infertile women accepted in vitro fertilization-embryo transplantation （IVF-ET） in our center were selected and were divided into observation group （n=200） and control group （n=188） based on the order of filing.In the control group，basic clinical nursing was provided such as regular health education guidance during ovulation induction，needling at night，and before and after egg retrieving and embryo transplantation and the like.The scores of self-rating anxiety scale （SAS） and self-rating depression scale （SDS），and questionnaire survey of patient′s satisfaction were carried out.In the observation group，SAS，SDS，and self-made questionnaire were measured during file-filling，needle-initiating，needling at night，egg retrieving，and embryo transplantation in order to know the psychological state and social demands of the patients during the treatment.After that，targeted mental nursing and health education guidance were adopted.The score of SAS and SDS，and patient′s satisfaction questionnaire after intervention measures were re-tested.The cycle cancellation rate，number of retrieved oocytes，the rate of high quality embryos，the clinical pregnancy rate，score of SAS and SDS，and questionnaire on patient′s satisfaction were observed in both groups.Results There was no great difference in the cycle cancellation rate，number of retrieved oocytes，the rate of high quality embryos or clinical pregnancy rate （P>0.05）.After intervention，the scores of SAS and SDS in the observation group were much lower than those in the control group （P<0.05）.The nursing satisfaction rate in the observation group （96%） was significantly higher than that in the control group accounting for 84% with statistical difference （P<0.05）.Conclusion For elderly female patients，in the process of performing with assisted reproductive technology，humanistic psychological nursing intervention can effectively relieve the psychological stress and improve patient′s satisfaction degree of treatment.

[Key words]Elderly women；Assisted reproductive technology；Nursing

在我国，由于“晚婚晚育”计划生育政策推行已久，加上高等教育在女性中的普及，女性生育年龄不断推迟，要求妊娠的高龄妇女不断增多。医学上定义超过35岁以上的生产者为高龄孕产妇。2016年1月1日我国全面推行 “二孩”政策，这一政策实施后，掀起高龄妇女的生育热潮。高龄育龄女性卵巢储备功能低下，妊娠率降低，流产率增高，生育的平均时间间隔延长，孕育的子代染色体异常概率增高，活产率降低[1]。探……