腰硬联合麻醉分娩镇痛对产后抑郁症影响.docVIP

腰硬联合麻醉分娩镇痛对产后抑郁症影响 　　【摘要】 目的：探讨腰硬联合麻醉分娩镇痛对产后抑郁症的影响。方法：2013年6月-2014年5月在本院采用蛛网膜下腔阻滞（腰麻）-硬膜外联合麻醉加产妇自控硬膜外镇痛（CSEA+PCEA）分娩镇痛并阴道分娩的初产妇101例为研究组，同期其他筛选条件相当的未采取任何分娩镇痛技术阴道分娩的初产妇105例为对照组，在第三产程末和产后5 d抽肘静脉血进行雌二醇（E2）、孕酮（P）检测，于产后5 d进行EPDS评分。结果：研究组产后5 d的EPDS评分和产后抑郁症发病率低于对照组（P0.05），但两组中产后抑郁者的产后5 d的E2低于正常产妇（P0.05）。结论：腰硬联合麻醉分娩镇痛降低了产后抑郁症的发生，分娩镇痛对产妇雌孕激素改变没有显著性差异的影响。 　　【关键词】 腰硬联合麻醉； 分娩镇痛； 产后抑郁症； 雌激素； 孕激素 　　【Abstract】 Objective： To explore the influence of combined spinal-epidural anesthesia of labor on postnatal depression. Method： 101 primigraida of spontaneous labor who accepted combined spinal-epidural anesthesia and patient-controlled epidural analgesia of labor（CSEA+PCEA） in our hospital from June 2013 to May 2014， were chosen as the experimental group， 105 primigraida of spontaneous labor who did not accept any anesthesia of labor at the same time as the control group. Monitored the numerical value of estradiol （E2） and progestin（P） at the end of the third stage of labor and the postpartum fifth day. To make EPDS scores on the postpartum fifth day. Result： The EPDS scores and the incidence of postnatal depression in the experimental group were significantly lower than those in the control group （P0.05）. But the levels of E2 in the patients with postpartum depression were significantly lower than those in the normal puerpera in the postpartum fifth day （P0.05）. Conclusion： Analgesia of labor can decrease the incidence of postnatal depression. Labor analgesia has no significant influence to the change of levels of E2 and P. 　　【Key words】 Combined spinal-epidural anesthesia； Labor analgesia； Postnatal depression； Estrogen； Progestational hormone 　　First-author’s address： Maternal and Child Health Hospital of Zhuhai City， Zhuhai 519000， China 　　doi：10.3969/j.issn.1674-4985.2014.22.017 　　产后抑郁（post parturm depression， PPD）是一种精神健康上的疾患，全球约有10%～25%产后妇女罹患此病[1]，我国发生率约10%～30%[2]，它不但影响产妇的身心健康，而且对婴儿的身心健康和家庭的稳定性都存在一定的影响。本文通过对腰硬联合麻醉分娩镇痛（以下简称分娩镇痛）和不采用任何镇痛技术阴道分娩的初产妇，比较第三产程末和产后5 d的雌二醇（E2）、孕酮（P