胎儿引导图像对妊娠期产妇心理情绪及皮质醇水平的影响  

Effects of fetal guidance image on the psychological mood and cortisol levels of pregnant women

作　　者：高丽娜[1] 李贤[2] 侯慧卿[3] 郑美洁[4] 王杰[5] 安楠[6] 霍琰[7] GAO Lina;LI Xian;HOU Huiqing(Central Supply Room,Hebei General Hospital,Hebei,Shijiazhuang 050051,China;不详)

机构地区：[1]河北省人民医院中心供应室,石家庄市050051 [2]河北省人民医院护理部,石家庄市050051 [3]河北省人民医院体检中心,石家庄市050051 [4]河北省人民医院内分泌科,石家庄市050051 [5]河北省人民医院干部保健科,石家庄市050051 [6]河北省人民医院肿瘤二科,石家庄市050051 [7]河北省人民医院产科,石家庄市050051

出　　处：《河北医药》2021年第22期3401-3404,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:20170372)。

摘　　要：目的研究胎儿引导图像对妊娠期产妇心理情绪及母体皮质醇水平的影响。方法研究筛选2015年1月至2017年11月126例妊娠期产妇做观察对象,对所有产妇进行胎儿超声引导图像,18 min引导图像放松操作中,详细记录入院时、检测开始、检测结束、离开时孕妇心理情绪变化[汉密尔顿焦虑量表(HAMA)、贝克抑郁自评量表(BDI)、恐惧视觉模拟评分(FAVS)]及母体雌激素水平。评估超声引导前、超声扫描、基线后、放松后、恢复后、离开对皮质醇、心率、呼吸周期变化。结果产妇胎儿引导图像期间,BDI评分差异无统计学意义(P>0.05);而检测开始时产妇HAMA评分FAVS评分较入院时明显升高(P<0.05);在胎儿引导图像基线后明显低于超声扫描(P<0.05);而放松后皮质醇水平低于基线后(P<0.05);恢复后产妇母体皮质醇水平又低于放松后(P<0.05)。母体雌激素水平与孕激素水平在患者入院时、检查开始、检查结束及离开等不同时点,差异均无统计学意义(P>0.05)。开始检测时母体IES-R量表回避性、高警觉性、侵扰性等评分较入院时升高(P<0.05)。Spearman因素分析,心理应激水平IES-R、焦虑情绪HAMA、恐怖情绪FAVS评分与胎儿超声引导图像检查呈正相关(P<0.05);皮质醇水平变化与胎儿超声引导图像事件呈负相关(P<0.05);而其余指标与胎儿超声引导图像检测无相关性(P>0.05)。结论胎儿与母体自主性之间存在关联,超声引导图像期间孕妇可能出现心理情绪变化,唾液皮质醇水平会逐渐下降。Objective To investigate the effects of fetal guidance image on the psychological mood and cortisol levels of pregnant women.Methods A total of 126 pregnant women who underwent prenatal examination in our hospital were from January 2015 to November 2017 were enrolled in the study,who were examined by fetal ultrasound-guided images.During the 18min guided image relaxation operation,the physiological responses of pregnant women at different time points were recorded in detail,including respiratory sinus arrhythmia,respiratory apparatus,skin conductance,and the maternal cortisol levels were measured,moreover,its effects on cortisol levels,heart rate and respiratory cycle at different time points were evaluated.Results There were was no significant changes in BDI score at fetal guidance image period,but the HAMA scores and FAVS scores of pregnant women were gradually increased at the beginning of the examination,compared with those on admission(P<0.05).The maternal cortisol levels after relaxation were significantly lower than those of baseline,after recovery of pregnant women,which were significantly lower than those of pregnant women after relaxation(P<0.05).At the time of admission,the beginning of examination,the end of examination and leaving,the maternal estrogen level and progesterone level did not fluctuate significantly,compared with the previous period(P>0.05).Pearman factor analysis showed that the scores of IES-R,HAMA and favs of psychological stress were positively correlated with fetal ultrasound-guided image examination(P<0.05);The changes of cortisol level were negatively correlated with fetal ultrasound-guided image events(P<0.05);Other indexes had no correlation with fetal ultrasound-guided image detection(P>0.05).Conclusion There exists a correlation between foetus and maternal autonomy.During ultrasound-guided imaging,pregnant women may have psychological and emotional changes,and the levels of salivary cortisol may be gradually decreased.

关 键 词：母体皮质醇 胎儿引导图像 产妇心理情绪 妊娠期产妇 

分 类 号：R714.2[医药卫生—妇产科学]