子宫托治疗对症状性盆腔器官脱垂患者广泛性焦虑障碍的影响
Effect of the pessary treatment on anxiety disorder in patients with symptomatic pelvic organ prolapse
摘要目的:分析子宫托治疗对症状性盆腔器官脱垂(POP)患者广泛性焦虑障碍的影响。方法:本研究为前瞻性队列研究,纳入北京协和医院妇科2018年12月至2020年1月≥18岁213例因POP行子宫托治疗的患者。子宫托试戴成功的标准定义为戴托2周主观症状改善满意并愿意继续戴托;或更换新的子宫托后再次试戴2周效果满意并愿意继续戴托。采用广泛性焦虑障碍量表(GAD-7)对163例试戴成功患者和50例失败患者进行子宫托治疗前后的焦虑评估,评分为10分及以上为中重度焦虑,定义为焦虑障碍,并继续对成功组进行3个月随访。比较两组治疗前后焦虑障碍患病率及焦虑障碍GAD-7评分差异。结果:研究对象年龄为(67.4±9.2)岁。治疗前,治疗成功组(34/163,20.9%)和失败组(10/50,20.0%)焦虑障碍患病率差异无统计学意义( P=0.896)。对完成随访患者进一步分析显示,焦虑障碍组(34例)和非焦虑障碍组(129例)的基本特征和临床特征差异均无统计学意义( P>0.05)。子宫托治疗3个月后,焦虑障碍的患病率从治疗前20.9%(34例)降至治疗后3.7%(6例)( P<0.001)。治疗前,焦虑障碍患者GAD-7评分 M( Q1, Q3)为16.0(12.5,21.0),降至治疗后的1.0(0,4.0)( P<0.001)。 结论:约20%症状性POP患者伴有中重度广泛性焦虑障碍,子宫托治疗3个月后,POP患者焦虑障碍的患病率下降。
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abstractsObjective:To evaluate the effect of the pessary treatment on general anxiety disorder in patients with symptomatic pelvic organ prolapse (POP).Methods:Between December 2018 and January 2020, 213 patients who received the pessary treatment for symptomatic POP in the Peking Union Medical College Hospital (PUMCH) were enrolled in this prospective observational study. Accepting the pessary successfully means that the patient keeping the pessary for 2 weeks were satisfied with it and willing to use it afterwards, or means that the patient having changed a new pessary and keeping it for 2 weeks were satisfied with it and willing to use it afterwards. The questionnaire General Anxiety Disorder-7 (GAD-7) was used to assess the anxiety state of POP patients, including 163 patients who accepted the pessary treatment successfully and 50 patients who failed, before and after the pessary treatment. A score of 10 or more was considered as the moderate or severe anxiety and defined as the anxiety disorder. Patients who accepted the pessary treatment successfully were followed up for 3 months.Results:Before the treatment, the prevalence of anxiety disorders was 20.9% (34 out of 163) for those patients accepting the pessary and that was 20.0% (10 out of 50) for those patients who failed in keeping the pessary, the difference of which were not statistically significant ( P=0.896). The difference of demographic data and clinical characteristics between the anxiety disorder group and the non-anxiety disorder group were not statistically significant ( P>0.05). After 3 months of the pessary treatment for those patients using the pessary treatment, the prevalence of anxiety disorders dropped to 3.7% (6/163) from 20.9% ( P<0.001). The GAD-7 score of patients with anxiety disorders decreased from a median of 16.0 (12.5, 21.0) before the treatment to 1.0 (0, 4.0) after the treatment, and the difference was statistically significant ( P<0.001). Conclusion:Around 20% POP patients receiving pessary treatment had the moderate or severe general anxiety disorder. After 3 months of using the pessary treatment, the prevalence of anxiety disorders in POP patients had dropped significantly.
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