宫内节育器放置术对使用者心理状态的影响  

Impact of intrauterine device insertion surgery on women＇s mental state

作　　者：楚光华[1] 邹燕[2] 王晓晔[3] 李素霞[4] 黄紫蓉[5] 方爱华[6] 田爱平 

机构地区：[1]中国医学科学院北京协和医学院研究生院,100730 [2]国家人口计生委科学技术研究所女性临床室 [3]北京大学第三医院妇产科 [4]北京大学药物依赖性研究所精神科 [5]复旦大学附属妇产医院妇产科 [6]上海交通大学医学院附属国际和平妇幼保健院妇产科 [7]四川省计划生育科研所门诊部

出　　处：《中华妇产科杂志》2013年第6期442-446,共5页Chinese Journal of Obstetrics and Gynecology

基　　金：国家科技支撑计划（2006BA115810）

摘　　要：【摘要】目的探讨宫内节育器（IUD）放置术对育龄妇女心理状态的影响。方法自2009年1月1日至2010年6月30日采用多中心临床观察的方法，在全国18个医疗和计划生育服务机构选取接受IUD放置术的观察对象641例，采用症状自评量表（SCL-90）对观察对象手术前后的心理状态进行测评，分析比较手术前后心理状态的变化情况及影响因素。结果641例观察对象中完成术后1个月随访并填写SCL-90量表者共575例。IUD放置术前、后观察对象SCL-90量表10个因子的得分均在1．1～1．2分，手术前、后总分分别为（107±27）、（105±25）分，手术前、后总均分均为1．2分、阳性症状均分均为2．1分，手术前、后分别比较，差异均无统计学意义（P〉0．05）。观察对象术前和术后阳性项目发生率分别在9．2％-19．6％和7．7％～17．6％，除焦虑和恐惧因子外，术后其余各因子（躯体化、强迫、人际关系、抑郁、敌对、偏执、精神病性、其他）阳性项目发生率明显低于术前，分别比较，差异均有统计学意义（P〈0．05）。观察对象术后的心理状态在SCL-9010个因子得分方面，“变差”者的发生率在4．9％～23．0％，“好转”者的发生率在26．3％-50．1％；总分“变差”者的百分率为28．8％（166／575），“好转”者的百分率为45．6％（262／575）；阳性症状均分“变差”者的百分率为3．7％（21／575），“好转”者为52．3％（301／575）。logistic回归分析显示，除IUD放置机构的级别外，其余各因素对于观察对象术后心理状态的变化均无明显影响（P〉0．05）。结论IUD放置术对妇女术后的心理状态无不利影响。Objective To evaluate the impact of the intrauterine device （IUD） insertion on the mental state of women. Methods From Jan. 2009 to Jun. 2010, a multi-center clinical observational study was performed. Totally 641 women were selected in the six provinces＇ 18 family planning service stations and hospitals for IUD insertion surgery study. Analysis of the change of women＇s mental state which was evaluated by symptom checklist-90 （SCL-90） scale before and after IUD insertion surgery. Results Before and after IUD insertion surgery, 10 factors＇ scores in SCL-90 of the observed objects were between 1.1 to 1.2, total scores were 107 _＋ 27 and 105 _＋ 25, respectively. Before and after surgery, total average score both were 1.2, the average score of positive items both were 2. 1. The difference of the above results were not statistically significance （ all P 〉 0. 05 ）. Preoperative and postoperative, the rate of positive items was 9. 2% - 19. 6% and 7.7% - 17. 6%, respectively. In addition to anxiety and fear, the rate of other factors＇ positive items postoperative was significantly lower than those in the preoperative （ all P 〈 0.05 ）. The incidence of the observed objects postoperative of each factor score, ＂deteriorated＂ was in the range of 4. 9% to 23.0% ,＂improved＂ was in the range of 26. 3% -50. 1%. The incidence of total scores, ＂deterioration＂ was 28.8% （166/575）, ＂improved＂ was 45.6% （262/575）. The incidence of the average score of positive items, ＂deterioration＂ was 3.7% （21/575）, ＂improved＂ was 52. 3% （301/575）. Logistic analysis showed that, in addition to unit level, there were no other significant influencing factors for women＇ mental state of postoperative （all P 〉 0. 05）. Conclusion IUD insertion surgery has no adverse effect on women＇s mental state.

关 键 词：宫内避孕器 避孕 精神病状态评定量表 心理测定学 育龄妇女 

分 类 号：R1[医药卫生—公共卫生与预防医学]