目的 了解育龄期乳腺癌患者对子代健康和遗传风险担忧现状及其对癌症诊断前后生育意愿改变的影响。方法 于2019年11月—2020年9月,采用中文版癌症后生育忧虑量表(RCAC)-子女健康亚量表对广州市某三甲医院的230例育龄期乳腺癌患者进行调查,应用SPSS 26.0及PSM插件对结果进行统计分析。在进行子女健康亚量表得分低分组和中高分组患者的生育意愿改变率的比较时,应用倾向性评分匹配法控制混杂因素。结果 育龄期乳腺癌患者对子代健康和遗传风险担忧得分为(11.40±2.99)分;匹配前后不同子女健康亚量表得分分组的患者在癌症诊断前后生育意愿改变率的差异均不具有统计学意义(P>0.05)。结论 育龄期乳腺癌患者对子代健康和遗传风险的担忧虽然没有显著影响其生育意愿的改变,但其对子代健康和遗传风险担忧处于较高水平,临床医护人员应提高对这一现象的重视,可通过多渠道科普相关知识,开展遗传咨询服务以减轻患者的担忧。
Objective To explore the current status of childbearing age breast cancer patients’ concerns about their children’s health and genetic risk and its influence on the change of fertility intention before and after cancer diagnosis.Methods From November 2019 to September 2020,the Chinese version of the Reproductive Concern After Cancer Scale(RCAC)- Children’s Health Sub-scale was used to interview 230 patients with breast cancer of childbearing age in a tertiary hospital in Guangzhou,and SPSS 26.0 and PSM plug-in were used to analyze the results statistically.The propensity score matching method was used to control confounding factors when comparing the change rate of fertility intention of patients with low scores and those with medium and high scores in the children health subscale.Results The score of concern for the health and genetic risk of children in breast cancer patients of childbearing age was(11.40±2.99).There was no statistically significant difference in the change rate of fertility intention before and after cancer diagnosis among patients with different subscale scores of children’s health.Conclusions Despite not significantly impacting fertility intentions,the notably high level of concern regarding children’s health and genetic risks among childbearing-age breast cancer patients necessitates increased clinical awareness.It is recommended that healthcare professionals address this through multi-channel education and genetically focused counseling within a collaborative model to mitigate patient distress.
目的 研究子宫内膜异位症生育指数(EFI)评分对子宫内膜异位症(EMT)患者腹腔镜术后生育指导的应用价值。方法 对2015年3月—2017年4月于我院进行腹腔镜手术治疗的76例EMT患者进行EFI评分,并依据其结果施加相应生育指导,随访2年观察患者术后妊娠情况。结果 随访2年结果显示,76例患者共出现68例妊娠,且其妊娠率及自然妊娠率随EFI评分减少而降低,组间均有性差异(P<0.05);68例妊娠患者足月分娩率为76.47%,同时不同EFI评分患者不良妊娠结局比较,组间均无显著性差异(P>0.05)。结论 腹腔镜手术能够提高EMT患者妊娠率及自然分娩率,同时可根据EFI评分,综合评估患者的生育状况,对于指导术后处理的选择以及指导后续治疗均有重要参考意义。
Objective To study the application value of uterine endometriosis index (EFI) on the postoperative reproductive guidance of patients with endometriosis (EMT). Methods From March 2015 to April 2017,76 EMT patients in our hospital underwent laparoscopic surgery for EFI score. On the basis of corresponding guidance,the patients were followed up and observed for 2 years for results in postoperative pregnancies. Results The two-year follow-up period showed that there were 68 cases of pregnancy in 76 cases. Pregnancy rate and natural pregnancy rate decreased with the decrease of EFI score. There was a difference between the groups (P<0.05). The monthly delivery rate of 68 cases was 76.47%. At the same time,there were no significant differences between the groups in the pregnancy outcomes of patients with different EFI scores (P>0.05). Conclusion Laparoscopic surgery can improve pregnancy rate and natural delivery rate of EMT patients. At the same time,according to the EFI score,comprehensive assessment of the patient's reproductive status is important for guiding the selection of postoperative treatment and for guiding follow-up treatment.
目的 研究益精汤对改善男性不育症患者精子质量和提高生育率的临床疗效。方法 将符合纳入标准的100例男性不育症患者随机分为益精汤组和五子衍宗片组进行治疗,治疗后采用ZKPACS-E彩色精子质量分析系统检测精子各项参数标指和调查孕育人数,进行分析对比。结果 通过治疗前后对比,益精汤组的治愈率及临床治愈率较五子衍宗片组高,益精汤组、五子衍宗片组总有效率依次是82%、64%,差异有统计学意义(P<0.05)。益精汤组对患者的精液液化时间、精子活力等指标方面的恢复和改善优于对照组。结论 益精汤能显著提高精子的质量,在治疗男性不育症方面效果显著,值得进一步临床研究和推广。