PCIA联合文拉法辛对下肢骨折伴焦虑抑郁患者负性情绪和睡眠的影响  

Effects of PCIA combined with venlafaxine on negative mood and sleep in patients with lower limb fractures and anxiety and depression

作　　者：代党会 陈燕[2] 李军[3] DAI Danghui;CHEN Yan;LI Jun(Department of Anesthesiology,General Hospital of Hebi Coul Industry(Group)Co.,Ltd.Hebi 458030,China)

机构地区：[1]鹤壁煤业(集团)有限责任公司总医院麻醉科,鹤壁458030 [2]郑州大学第二附属医院麻醉科 [3]贵州医科大学第一附属医院神经内科

出　　处：《国际精神病学杂志》2020年第3期566-569,共4页Journal Of International Psychiatry

摘　　要：目的病人自控镇痛(patient controlled intravenous analgesia,PCIA)联合文拉法辛对下肢骨折伴焦虑抑郁患者负性情绪和睡眠的影响。方法选取我院2016年4月~2019年8月收治的98例下肢骨折伴轻度抑郁焦虑患者作为本次研究的对象,按随机数字表法将研究对象随机分为研究组和对照组,每组各49例。对照组(49例)术后予PCIA镇痛+安慰剂,研究组(49例)予PCIA镇痛+文拉法辛治疗;观察对比两组患者干预前后汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、匹茨堡睡眠质量指数量表评分(PSQI)评分和血清神经递质水平,及干预后视觉模拟评分法(VAS)评分。结果术后4h^48h两组患者的VAS评分差异无统计学意义(P>0.05);干预后,研究组患者的HAMA、HAMD及PSQI评分明显低于对照组(P<0.01),而血清5-HT、NE水平均高于对照组(P<0.01);两组患者的不良反应发生率差异无统计学意义(P>0.05)。结论文拉法辛能够有效缓解下肢骨折伴焦虑抑郁的患者的负性情绪,改善睡眠质量,其机制可能与提高血清5-HT和NE水平相关。Objective To investigate the effect of PCIA combined with venlafaxine on negative mood and sleep in patients with lower limb fractures and anxiety and depression. Methods A total of 98 patients with lower limb fracture and anxiety and depressionin our hospital from April 2016 to August 2019 were collected and randomly divided into two groups :control group(49 cases)received PCIA + placebo,and the study group(49 cases)received PCIA + venlafaxine. Hamilton depression scale(HAMD)score,Hamilton anxiety scale(HAMA)score,Pittsburgh sleep quality index(PSQI)score and serum neurotransmitter level before and after intervention,and visual analogue scale(VAS)score after intervention were compared. Results There was no significant difference in VAS scores between the two group from 4 h to 48 h after surgery(P>0.05). After intervention,the HAMA,HAMD and PSQI scoresin the study group were lower than those inthe control group,serum 5-HT,NE in the study group were higher than that in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two group(P>0.05). Conclusion Venlafaxine can effectively relieve the negative emotions and improve the sleep quality of patients with lower limb fractures associated with anxiety and depression,and its mechanism may be related to the increase of serum 5-HT and NE levels.

关 键 词：下肢骨折 焦虑 抑郁 静脉自控镇痛 文拉法辛 

分 类 号：R749.99[医药卫生—神经病学与精神病学]