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医护合作的遗传咨询和随访模式在遗传性妇科肿瘤变异基因携带者健康管理中的作用研究

Study on the role of genetic counseling and follow-up mode of medical cooperation in the health management of carriers of genetic gynecological tumor variants
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摘要 目的建立医护合作的遗传性妇科肿瘤变异基因携带者遗传咨询和随访模式,评价其实践效果。方法选取2021年1月至2023年6月于复旦大学附属妇产科医院妇科肿瘤遗传咨询门诊就诊的70例遗传性妇科肿瘤携带者作为研究对象,随机分为对照组和观察组,每组35例。对照组行常规肿瘤遗传咨询门诊管理方式,观察组行医护合作的遗传咨询和随访模式。于干预前、干预后6个月评价两组变异基因携带者心理焦虑-抑郁程度、心理危机感、生活质量及相关临床指标。结果在心理焦虑-抑郁程度方面,干预6个月后观察组明显低于对照组(P<0.05);在心理危机方面,干预6个月后观察组各维度得分均低于对照组(P<0.05);在生活质量方面,干预6个月后观察组除了躯体疼痛,其余7个维度评分均高于对照组(P<0.05)。干预6个月后,观察组行预防性输卵管-卵巢切除手术者8例、育龄期携带者成功行胚胎植入前遗传学检测助孕者4例,对照组例数均为0。结论医护合作的遗传性妇科肿瘤变异基因携带者遗传咨询和随访模式,可为变异基因携带者提供一个全周期、规范化、智能化的管理,降低心理焦虑-抑郁程度、心理危机感,改善其生活质量,并指导其采用科学的方法预防遗传性肿瘤的发生,为遗传性妇科肿瘤变异基因携带者的健康管理提供了实践依据。 Objective To establish a genetic counseling and follow-up model for hereditary gynecologic tumor variant gene carriers in medical and nursing cooperation,and to evaluate its practical effect.Methods A total of 70 hereditary gynecologic tumor carriers who were admitted to the Gynecologic Cancer Genetic Counseling Clinic,Obstetrics and Gynecology Hospital,Fudan University from Jan 2021 to Jun 2023 were randomly divided into control group and observation group,with 35 cases in each group.The control group underwent routine outpatient management of tumor genetic counseling,and the observation group underwent the genetic counseling and follow-up mode of medical and nursing cooperation.Before and 6 months after intervention,the degree of psychological anxiety-depression,psychological crisis,quality of life and related clinical indicators of the two groups of mutant gene carriers were evaluated.Results In terms of the degree of psychological anxiety and depression,the observation group was significantly lower than the control group after 6 months of intervention(P<0.05).In terms of psychological crisis,the scores of all dimensions in the observation group were lower than those in the control group after 6 months of intervention(P<0.05).In terms of quality of life.After 6 months of intervention,the scores of the observation group in all seven dimensions were higher than those in the control group(P<0.05).After 6 months of intervention,8 patients in the observation group underwent prophylactic salpingo-oophorectomy,4 patients in the childbearing age carrier successfully underwent preimplantation genetic testing,and the number of cases in the control group was 0.Conclusion The genetic counseling and follow-up mode of hereditary gynecologic tumor variant gene carriers can provide a full-cycle,standardized and intelligent management for mutant gene carriers,reduce the degree of psychological anxiety-depression,psychological crisis,improve their quality of life,and guide them to adopt scientific methods to prevent the occurre
作者 王辉 范芳琴 王霞 康玉 WANG Hui;FAN Fang-qin;WANG Xia;KANG Yu(Phase One Clinical Trials Unit,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200011,China;Department of Nursing,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200011,China)
出处 《复旦学报(医学版)》 CAS CSCD 北大核心 2024年第6期970-976,共7页 Fudan University Journal of Medical Sciences
基金 上海市申康医院发展中心临床科技创新项目(SHDC12020108)。
关键词 妇科肿瘤 遗传性 医护合作 变异基因携带者 健康管理 gynecological tumors genetic medical and nursing cooperation carriers of mutated genes health management
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