CAJ | 학술논문

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-90 10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.
목적 탐토궁내절육기(IUD)방치술대육령부녀심리상태적영향.방법 자2009년1월1일지2010년6월30일채용다중심림상관찰적방법,재전국18개의료화계화생육복무궤구선취접수IUD방치술적관찰대상641례,채용증상자평량표(SCL-90)대관찰대상수술전후적심리상태진행측평,분석비교수술전후심리상태적변화정황급영향인소.결과 641례관찰대상중완성술후1개월수방병전사SCL-90량표자공575례.IUD방치술전、후관찰대상SCL-90량표10개인자적득분균재1.1～1.2분,수술전、후총분분별위(107±27)、(105±25)분,수술전、후총균분균위1.2분、양성증상균분균위2.1분,수술전、후분별비교,차이균무통계학의의(P＞0.05).관찰대상술전화술후양성항목발생솔분별재9.2％～19.6％화7.7％～17.6％,제초필화공구인자외,술후기여각인자(구체화、강박、인제관계、억욱、활대、편집、정신병성、기타)양성항목발생솔명현저우술전,분별비교,차이균유통계학의의(P＜0.05).관찰대상술후적심리상태재SCL-90 10개인자득분방면,“변차”자적발생솔재4.9％～ 23.0％,“호전”자적발생솔재26.3％～50.1％；총분“변차”자적백분솔위28.8％(166/575),“호전”자적백분솔위45.6％(262/575)；양성증상균분“변차”자적백분솔위3.7％ (21/575),“호전”자위52.3％ (301/575).logistic회귀분석현시,제IUD방치궤구적급별외,기여각인소대우관찰대상술후심리상태적변화균무명현영향(P＞0.05).결론 IUD방치술대부녀술후적심리상태무불리영향.
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.