全产程阵痛对产妇围产期心理影响研究.docVIP

全产程阵痛对产妇围产期心理影响研究 　　[摘要] 目的 探讨在产妇分娩过程中全产程镇痛对产妇围产期心理的影响。 方法 选择经阴道分娩产妇120名随机分为对照组及研究组，研究组在分娩过程中采用腰硬联合麻醉镇痛，采用视觉模拟评分法（VAS）评价两组分娩过程疼痛差异，采用产妇抑郁量表（EPDS）及汉米尔顿焦虑量表（HAMA）评估两组产妇围产期心理变化。 结果 研究组第一产程、第二产程及胎儿娩出后VAS评分低于对照组，产后1个月研究组EPDS评分及产后抑郁发生率低于对照组，产后1周研究组HAMA评分及焦虑发生率低于对照组。 结论 腰硬联合镇痛能够减轻分娩过程中疼痛的痛苦体验，减少产后焦虑及抑郁的发生。 　　[关键词] 分娩镇痛；抑郁；焦虑；视觉模拟评分法 　　[中图分类号] R714.3 [文献标识码] B [文章编号] 1673-9701（2012）02-0089-03 　　 　　Effect of analgesia during the whole stages of labor to psychology on puerpera 　　XIE Shuzhen 　　Department of Obstetrics and Gynaecology, Hangzhou Iron and Steel Group Company Hospital, Hangzhou 310022, China 　　[Abstract] Objective To investigate the effect of analgesia during the whole stages of labor to psychology on puerpera. Methods All 120 cases who would taken spontaneous delivery were selected and divided into control group and research group, puerpera in research group taken nalgesia during the whole stages of labor topsychology,difference of pains were evaluated with VAS and change of mental were contrasted with EPDS and HAMA. Results Results score of VAS in first birth process,in second birth process and after parturition was lower in research groups than in control groups,score of EPDS and incidence of postpartum depression was lower in research, Score of HAMA and incidence of anxiety was lower in research groups than control groups in 1 week after parturition. Conclusion Analgesia during the whole birth process could decreas labor pains, decrease incidence rate of anxiety and postpartum depression. 　　[Key words] Parturition analgesia; Postpartum depression; Anxiety mental; VAS 　　 　　围产期是产妇的特殊生理时期，在围产期由于生理及生活方式的改变，患者处于心理应激状态，容易发生心理异常，产痛是最为严重的不良生理及心理刺激因素之一，强烈的疼痛刺激能够引起机体应激反应，甚至诱发器官???统的功能障碍。采用干预手段减轻分娩过程中的疼痛对于维护产妇的心理及生理健康具有重要意义[1]，近年来我院采用硬腰联合麻醉技术进行分娩镇痛，对于维护患者身心健康取得较好的效果，现报道如下。 　　 　　1 资料与方法 　　1.1 临床资料 　　选择2006年1月~2010年12月在我院产科待分娩初产孕妇120例，年龄23~36岁,平均（25.2±4.8）岁，孕37~41周，平均（38.0±1.6）周。所有产妇术前评估符合经阴道分娩条件，无硬膜外镇痛禁忌证。产妇入选后随机分为研究组及对照组，两组产妇的年龄、体重、妊娠时间经统计学分析无显著差异（P0.05），