孕产期心身障碍临床路径(2017版)  

Clinical pathway for psychosomatic disorders in pregnancy and puerperium(2017)

作　　者：秦峰 李丽娟[2] 肖利军 张立新 郜正美 蓝海英 王盈力 赵娟娟 王爱玲 韩代花 王月华 

机构地区：[1]全国孕产妇心身健康门诊总课题组,北京100142 [2]中国疾病预防控制中心妇幼保健中心,北京100098 [3]陆军总医院附属八一儿童医院科研室,北京100700 [4]天津市滨海新区大港妇女儿童保健中心孕产妇心身健康门诊研究基地,300270 [5]杭州市临安区妇幼保健计划生育服务中心孕产妇心身健康门诊研究基地,311300 [6]广州市越秀区妇幼保健院孕产妇心身健康门诊研究基地,510055 [7]烟台市烟台山医院孕产妇心身健康门诊研究基地,山东264000 [8]新疆维吾尔自治区妇幼保健院孕产妇心身健康门诊研究基地,乌鲁木齐830001 [9]焦作市妇幼保健院孕产妇心身健康门诊研究基地,河南454150 [10]成都市双流区妇幼保健院孕产妇心身健康门诊研究基地,610200 [11]德保县妇幼保健院孕产妇心身健康门诊研究基地,广西百色533700

出　　处：《中华妇幼临床医学杂志（电子版）》2017年第6期640-644,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：中国博士后科学基金(2012M521923)~~

摘　　要：孕产期心身障碍(PSD)是指由孕产妇心理问题诱发的躯体化功能性障碍。孕产期PSD可诱发妊娠相关疾病,不仅影响胎儿正常发育,还可导致早产、自然流产及产后相关并发症,对分娩方式、产程及新生儿健康,亦产生极大影响。产生上述不良影响的基本因素是孕产妇的心理问题,直接临床表现为孕产期PSD,普遍出现多梦、易醒、入睡困难、尿频、恶心、呕吐、胃胀、便秘、胸闷、心悸、口干、肌肉酸痛12项躯体功能障碍症状。全国孕产妇心身健康门诊总课题组,通过对全国多中心孕产妇心身健康门诊研究基地的大样本临床数据进行研究的结果显示,应用多学科合作的生理调控、心理调节、音乐调理(PPM)诊疗系统,针对罹患孕产期PSD的孕妇进行治疗,对躯体功能障碍症状的临床有效率为92.23%,对焦虑、抑郁高危因素产生积极影响的有效率为99.48%,经孕产妇心身健康门诊治疗痊愈后2个月的康复率为91.50%。这些系列研究结果提示孕产期PSD可控、可治。通过深入研究"孕产妇心身健康门诊及孕产期PSD诊疗体系的创建与应用"这一课题,本课题组基于既往相关研究成果,制定《孕产期心身障碍临床路径(2017版)》,为进一步深入研究孕产期PSD提供临床标准。Psychosomatic disorders （PSD） in pregnancy and puerperium is defined as functional somatization disorders in pregnant and puerperal woman induced by mental health problems, which may cause pregnancy-related diseases, resulting in impaired fetal normal development as well as premature delivery, miscarriage and postpartum complications, and severely affect the delivery mode, labor process and health of newborns. The causes of above mentioned adverse effects are mental health problems of pregnant and puerperal women, which are clinically manifested as PSD in pregnancy and puerperium, including 12 somatic dysfunction symptoms as frequent dreaming, restless sleep, difficulty falling asleep, frequent urination, nausea, vomiting, gastric distention, constipation, chest distress, palpitation, dry mouth and sore muscle. The analysis of clinical data on large number of samples from multiple study bases of psychosomatic health outpatients for pregnant women across China performed by general research group of National Maternal Physical and Mental Health Clinic showed that, the multidisciplinary cooperation mode of physiological regulation, psychological adjustment and music conditioning （PPM） had a clinical effective rate of 92. 23% and 99. 48% in resolving somatic dysfunction symptoms and high-risk factors of anxiety and depression in pregnant and puerperal women with PSD, respectively, and a recovery rate of 91. 500//00 2 months after cure in Psychosomatic Health Outpatient for Pregnant Women. This series of studies suggested that PSD in pregnancy and puerperium is controllable and curable. By conducting in depth studies on ＂maternal psychosomatic health clinic and establishment and application of PSD in pregnancy management system＂, the general research group developed the 2017 Clinical Pathway for PSD in Pregnancy and Puerperium based on results of previous related studies, providing clinical standards for further developmental studies.

关 键 词：心理生理性障碍 躯体型障碍 临床路径 孕妇 产妇 

分 类 号：R473.71[医药卫生—护理学]