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目的:分析影响再生育高龄妇女行辅助生殖技术妊娠成功率的因素,确定护理要点。方法:选取200例行辅助生殖技术助孕的再生育妇女为研究对象,根据生育二胎妇女的年龄<35岁,35~40岁,>40岁,将其分为3组,以<35岁为对照组,对失独、再婚和按政策生育等原因进行年龄、卵巢储备功能评估指标和妊娠率分析。根据卵巢储备功能指标建立以年龄为基础,以再生育原因为重点的分层护理模式。结果:生育二胎妇女中≥35岁者占79%,35岁以后临床妊娠率急剧下降,明显低于对照组(P<0.01);≥35岁组卵巢储备功能实验重要指标AMH、AFC水平较对照组显著下降(P<0.01),>40岁组FSH水平较对照组显著升高(P<0.01);>40岁组无论卵巢功能正常与否临床妊娠率都极低。妇女生育二胎原因分析中,>40岁人群除了按政策生育二胎者,失独(失去独生子女)者占多数。结论:选择卵巢储备功能异常的高龄再生育妇女和失独再生育妇女作为护理重点。关注卵巢储备功能和心理状态的改变,采取有效护理方法降低高希望值和卵巢功能衰竭造成的低生育率对高龄再生育女性产生的负面影响。
OBJECTIVE: To analyze the factors influencing the success rate of pregnancy assisted reproductive technology in elderly women of reproductive age and to determine the main points of nursing. Methods: Two hundred and seventy reproductive women assisted by assisted reproductive technology were selected as study subjects. According to the age <35, 35-40,> 40 years old, For the control group, the loss of independence, remarriage and fertility by policy and other reasons for age, ovarian reserve function evaluation index and pregnancy rate analysis. According to ovarian reserve function indicators to establish an age-based, to reproduce the reasons for the focus of the layered nursing model. Results: The incidence of AMH and AFC in important stage of ovarian reserve function in 35 years old group was 79%, and the clinical pregnancy rate dropped sharply after 35 years old, which was significantly lower than that in control group (P <0.01) The control group decreased significantly (P <0.01). The FSH level of> 40 years old group was significantly higher than that of the control group (P <0.01). The clinical pregnancy rate of the group> 40 years old with or without ovarian function was very low. Women’s second child causes analysis,> 40-year-old population except in accordance with the policy of second child, loss of independence (loss of only child) accounted for the majority. CONCLUSIONS: Elderly reproductive women with abnormal ovarian reserve function and women who have lost their virginity are considered as the key points of nursing care. Concerned about changes in ovarian reserve function and psychological status, and effective nursing methods to reduce the high hopes and ovarian failure caused by low fertility negative impact on the elderly reproductive women.