椎管内分娩镇痛对产时焦虑/抑郁情绪障碍的影响(1)
【摘要】 目的 探讨椎管内分娩镇痛对产时焦虑/抑郁情绪障碍的影响。方法 选择阴道分娩的120名初产妇作为研究对象，其中镇痛组孕产妇55名，非镇痛组孕产妇47名，18名孕产妇因中转为剖宫产或产时失访被排除在外，分别于第一产程(潜伏期、活跃期)、第二产程以及第三产程对其进行面对面问卷调查(包括孕产妇人口统计学、社会经济学资料和标准化的疼痛程度数字评定量表、焦虑自评量表、爱丁堡产后抑郁量表)，比较2组中重度疼痛所占比例、焦虑/抑郁情绪障碍的发生率。结果 镇痛组第一产程(潜伏期、活跃期)、第二产程的中重度疼痛所占比例均低于非镇痛组(P均< 0.001)。镇痛组在活跃期、第二产程的焦虑情绪障碍发生率及第二产程中抑郁情绪障碍的发生率均低于非镇痛组(P均< 0.05)。结论 椎管内分娩镇痛可以缓解孕产妇产时的焦虑及抑郁情绪。
【关键词】 椎管内分娩镇痛;产时焦虑情绪;产时抑郁情绪;初产妇
Effect of intraspinal labor analgesia on intrapartum anxiety/depression emotional disorders Sheng Wei， Yang Jun， Cai Zhenyu， Yang Na， Li Wenying. Department of Obstetrics， Aviation General Hospital of China Medical University， Beijing 100012， China
Corresponding author， Cai Zhenyu， E-mail： czy220@ sina. com
【Abstract】 Objective To investigate the effect of intraspinal labor analgesia on intrapartum anxiety/depression emotional disorders. Methods A total of 120 primiparae who delivered vaginally were selected as subjects， including 55 in the analgesia group， 47 in the non-analgesia group， and 18 pregnant women were excluded due to switching to cesarean section or intrapartum lost to follow-up. Face-to-face questionnaires were conducted at the first stage of labor (incubation period， active period)， the second， and the third stages of labor (including maternal demography， socioeconomic data， and standardized numerical pain rating scale， self-rating anxiety scale， and the Edinburgh postpartum depression scale). The proportion of moderate to severe pain and the incidence of anxiety/depression emotional disorders were compared between the two groups. Results The proportion of moderate and severe pain in the first (incubation period， active period) and second stage of labor in the analgesia group was lower than that in the non-analgesia group (all P < 0.001). The incidence of anxiety disorders in the active stage and the second stage of labor， and the incidence of depression disorders in the second stage of labor were lower in the analgesic group than in the non-analgesic group， and the differences were statistically significant (all P < 0.05). Conclusion Intraspinal labor analgesia can relieve maternal anxiety and depression during childbirth.
【Key words】 Intraspinal labor analgesia;Intrapartum anxiety;Intrapartum depression emotion;
Primipara
圍产期孕产妇因生理、心理变化，同时伴随身份、责任的转变，极易诱发围产期抑郁[1]。围产期抑郁不仅影响孕产妇心理健康，而且其包括的产前和产时不良情绪也可能对分娩方式、产程、产后并发症和新生儿预后产生不良影响，孕产妇往往因难以忍受分娩疼痛及产时焦虑/抑郁情绪障碍而放弃阴道分娩选择中转剖宫产[2]。产时焦虑及抑郁可对孕产妇造成极其不良影响[3-4]。因此，对产时焦虑/抑郁情绪的识别与处理非常重要，本研究重点探讨初产妇的椎管内分娩镇痛对产时焦虑/抑郁情绪的影响。, http://www.100md.com(盛威?杨隽?蔡贞玉?杨娜?李文影)
【关键词】 椎管内分娩镇痛;产时焦虑情绪;产时抑郁情绪;初产妇
Effect of intraspinal labor analgesia on intrapartum anxiety/depression emotional disorders Sheng Wei， Yang Jun， Cai Zhenyu， Yang Na， Li Wenying. Department of Obstetrics， Aviation General Hospital of China Medical University， Beijing 100012， China
Corresponding author， Cai Zhenyu， E-mail： czy220@ sina. com
【Abstract】 Objective To investigate the effect of intraspinal labor analgesia on intrapartum anxiety/depression emotional disorders. Methods A total of 120 primiparae who delivered vaginally were selected as subjects， including 55 in the analgesia group， 47 in the non-analgesia group， and 18 pregnant women were excluded due to switching to cesarean section or intrapartum lost to follow-up. Face-to-face questionnaires were conducted at the first stage of labor (incubation period， active period)， the second， and the third stages of labor (including maternal demography， socioeconomic data， and standardized numerical pain rating scale， self-rating anxiety scale， and the Edinburgh postpartum depression scale). The proportion of moderate to severe pain and the incidence of anxiety/depression emotional disorders were compared between the two groups. Results The proportion of moderate and severe pain in the first (incubation period， active period) and second stage of labor in the analgesia group was lower than that in the non-analgesia group (all P < 0.001). The incidence of anxiety disorders in the active stage and the second stage of labor， and the incidence of depression disorders in the second stage of labor were lower in the analgesic group than in the non-analgesic group， and the differences were statistically significant (all P < 0.05). Conclusion Intraspinal labor analgesia can relieve maternal anxiety and depression during childbirth.
【Key words】 Intraspinal labor analgesia;Intrapartum anxiety;Intrapartum depression emotion;
Primipara
圍产期孕产妇因生理、心理变化，同时伴随身份、责任的转变，极易诱发围产期抑郁[1]。围产期抑郁不仅影响孕产妇心理健康，而且其包括的产前和产时不良情绪也可能对分娩方式、产程、产后并发症和新生儿预后产生不良影响，孕产妇往往因难以忍受分娩疼痛及产时焦虑/抑郁情绪障碍而放弃阴道分娩选择中转剖宫产[2]。产时焦虑及抑郁可对孕产妇造成极其不良影响[3-4]。因此，对产时焦虑/抑郁情绪的识别与处理非常重要，本研究重点探讨初产妇的椎管内分娩镇痛对产时焦虑/抑郁情绪的影响。, http://www.100md.com(盛威?杨隽?蔡贞玉?杨娜?李文影)
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