多囊卵巢综合征不孕患者治疗期间生活方式管理方案的构建及应用研究

doi:10.3761/j.issn.0254-1769.2023.02.002

摘要/Abstract

摘要：

目的构建多囊卵巢综合征（polycystic ovary syndrome，PCOS）不孕患者治疗期间生活方式管理方案并评价其临床应用效果。方法在证据总结和质性访谈的基础上构建PCOS不孕患者治疗期间生活方式管理方案。采用便利抽样法，选取南京市某三级甲等医院健康管理中心、生殖医学中心就诊的育龄期PCOS不孕患者作为研究对象，根据首次就诊时间，将2021年9月15日—30日收治的27例患者纳入试验组，通过评估、筛查、现状分析、制订体质量管理目标、饮食管理、运动管理、行为管理、健康指导、效果评价9个关键环节进行生活方式管理。将2021年2月15日—28日收治的27例患者纳入对照组，予以常规健康生活方式指导。比较两组干预前后的BMI、胰岛素抵抗指数、血清睾酮水平、焦虑水平、抑郁水平及疾病相关生活质量状况。结果干预后，试验组BMI为24.43±2.99，低于对照组的26.48±3.49；胰岛素抵抗指数为2.42±0.98，低于对照组的3.52±0.97；血清睾酮水平为（0.55±0.19） ng/ml，低于对照组的（1.20±0.42） ng/ml；广泛性焦虑量表得分为（5.73±2.13）分、患者健康问卷得分为（5.12±2.66）分，低于对照组的（9.40±2.36）、（10.60±2.58）分；修订版PCOS患者生存质量量表得分为（140.38±7.25）分，高于对照组的（115.56±7.99）分，差异均具有统计学意义（P<0.05）。结论实施PCOS不孕患者治疗期间生活方式管理方案，有利于调整患者内分泌代谢状态、缓解焦虑及抑郁情绪并提高其生活质量。

关键词: 多囊卵巢综合征, 生活方式, 生活质量, 护理

Abstract:

Objective To construct a lifestyle management scheme for infertile women with polycystic ovary syndrome（PCOS） during outpatient medical treatment，and to evaluate its clinical effects. Methods Based on the evidence summary and qualitative interviews，a lifestyle management scheme for infertile women with PCOS during medical treatment was constructed. The infertile women at childbearing age with PCOS from the health management center and reproductive medicine center of a tertiary A hospital in Nanjing were recruited through convenience sampling. 27 patients who visited the above mentioned 2 centers from September 15 to 30，2021 were recruited in an experimental group successively，while another 27 patients who visited there from February 15 to 28，2021 were recruited in a control group successively. Next，the lifestyle management scheme was implemented in the experimental group in 9 key steps，including evaluation，screening，status analysis，formulation of body mass management objectives，diet management，exercise management，behavior management，health guidance，and evaluation. Meanwhile，27 patients in the control group were given the routine healthy lifestyle guidance. After 3 months，the figure of BMI，insulin resistance index，serum testosterone，anxiety，depression and quality of life of the 2 groups were analysed. Results After the intervention，the BMI of the experimental group was 24.43±2.99，which was lower than （26.48±3.49） in the control group. The insulin resistance index was 2.42±0.98，which was lower than 3.52±0.97 in the control group. The level of testosterone was（0.55±0.19） ng/ml，which was lower than（1.20±0.42） ng/ml in the control group. The anxiety level was（5.73±2.13） and the depression level was（5.12±2.66），which were lower than（9.40±2.36） and（10.60±2.58） of the control group. The score of disease-related quality of life was（140.38±7.25），which was higher than（115.56±7.99） of the control group，and the differences were statistically significant （P<0.05）. Conclusion The implementation of the lifestyle management scheme for infertile women with PCOS during medical treatment is conducive to adjust patients’ endocrine and metabolic status，alleviate their anxiety and depression and improve quality of life.

Key words: Polycystic Ovary Syndrome, Life Style, Quality of Life, Nursing Care

卢山, 孙小玲, 王静, 王颖捷, 杨海明, 周建军, 杨燕, 张宁, 刘才琪, 刘亮, 沈迪文. 多囊卵巢综合征不孕患者治疗期间生活方式管理方案的构建及应用研究[J]. 中华护理杂志, 2023, 58(2): 141-149.

LU Shan, SUN Xiaoling, WANG Jing, WANG Yingjie, YANG Haiming, ZHOU Jianjun, YANG Yan, ZHANG Ning, LIU Caiqi, LIU Liang, SHEN Diwen. Construction and application of a lifestyle management scheme for infertile women with polycystic ovary syndrome during medical treatment[J]. Chinese Journal of Nursing, 2023, 58(2): 141-149.

图/表 4

表1 生活方式管理方案的具体实施内容

Table 1 The specific contents of the lifestyle management scheme

表2 两组一般资料比较[例（百分比，%）]

Table 2 Comparison of general data between the 2 groups [case（percentage， %）]

表3 两组干预前后内分泌代谢指标比较（$\bar{x} \pm s$）

Table 3 Comparison of endocrine and metabolic indexes between the 2 groups before and after intervention（$\bar{x} \pm s$）

表4 两组干预前后心理指标及生活质量比较（分，$\bar{x} \pm s$）

Table 4 Comparison of psychological indexes and quality of life between the 2 groups before and after intervention（score，$\bar{x} \pm s$）

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