孕产期心身障碍临床路径(2020修订版)  

Clinical pathway for pregnancy and puerperium psychosomatic disorders(2020 revised version)

作　　者：秦峰 郑军[2] 李丽娟[3] 张立新 李建娟 陈坤 卢春梅 蓝海英 庞强 陈双燕 陈瑶 李凤贤 李春宏 朱丽秋 杨凤英[15] Qin Feng;Zheng Jun;Li Lijuan;Zhang Lixin;Li Jianjuan;Chen Kun;Lu Chunmei;Lan Haiying;Pang Qiang;Chen Shuangyan;Chen Yao;Li Fengxian;Li Chunhong;Zhu Liqiu;Yang Fengying(General Research Group of National Psychosomatic Health Clinic for Pregnancy and Puerperium,Beijing 100142,China;Department of Neonatology,Tianjin Central Hospital of Gynecology and Obstetrics,Tianjin 300052,China;Maternal and Child Health Center,Chinese Center for Disease Control and Prevention,Beijing 100098,China;Research Base of Psychosomatic Health Clinic for Pregnancy and Puerperium of Dagang,Women and Children Health Care and Family Planning Service Center in Binhai New Area,Tianjin 300270,China;Research Base of Psychosomatic Health Clinic for Pregnancy and Puerperium,Beichen District Women and Children Health Care and Family Planning Service Center,Tianjin 300400,China;Research Base of Psychosomatic Health Clinic for Pregnancy and Puerperium,Shapingba District Women and Children Health Care and Family Planning Service Center,Chongqing 400030,China;Research Base of Psychosomatic Health Clinic for Pregnancy and Puerperium,Pidu District Women and Children Health Care Hospital,Chengdu 611745,Sichuan Province,China;Research Base of Psychosomatic Health Clinic for Pregnancy and Puerperium,Yuexiu District Women and Children Health Care Hospital,Guangzhou 510055,Guangdong Province,China;Research Base of Psychosomatic Health Clinic for Pregnancy and Puerperium,Debao Maternal and Child Health Care Hospital,Baise 533700,Guangxi Zhuang Autonomous Region,China;Research Base of Psychosomatic Health Clinic for Pregnancy and Puerperium,Lin′an District Women and Children Health Care and Family Planning Service Center,Hangzhou 311300,Zhejiang Province,China;Research Base of Psychosomatic Health Clinic for Pregnancy and Puerperium,Hangzhou Fuyang Women and Children Hospital,Hangzhou 311400,Zhejiang Province,China;Research Base of Psychosomatic Health Clinic for Pregnancy and Puerperium,Meihekou Women and Children Health Care Hospital,Meihekou 135000,Jilin P

机构地区：[1]全国孕产妇心身健康门诊总课题组,北京100142 [2]天津市中心妇产科医院新生儿科,300052 [3]中国疾病预防控制中心妇幼保健中心,北京100098 [4]天津市滨海新区妇女儿童保健和计划生育服务中心大港孕产妇心身健康门诊研究基地,300270 [5]天津市北辰区妇女儿童保健和计划生育服务中心孕产妇心身健康门诊研究基地,300400 [6]重庆市沙坪坝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,400030 [7]成都市郫都区妇幼保健院孕产妇心身健康门诊研究基地,611745 [8]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 [9]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 [10]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 [11]杭州市富阳区妇幼保健院孕产妇心身健康门诊研究基地,311400 [12]梅河口市妇幼保健院孕产妇心身健康门诊研究基地,吉林135000 [13]安达市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,黑龙江151400 [14]东宁市妇幼保健院孕产妇心身健康门诊研究基地,黑龙江157200 [15]巴彦淖尔市医院孕产妇心身健康门诊研究基地,内蒙古自治区015000

出　　处：《中华妇幼临床医学杂志（电子版）》2020年第5期535-542,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：中国健康促进基金会身心健康基金(CHSX20190601)。

摘　　要：在生物-心理-社会医学模式下,孕产期心身障碍(PPPSD)是指孕产妇集心理-妊娠期生理-社会因素的“心-身”作用,或集妊娠期生理、病理危险因素的“身-心”作用,或二者共存相互作用,导致的个体躯体功能障碍。孕产妇发生PPPSD,可严重影响产科医疗质量,对孕产妇、胎儿及新生儿健康造成极大危害。全国孕产妇心身健康门诊总课题组(以下简称为“总课题组”)对PPPSD的病因、发病机制、诊断、治疗、预后及康复等进行研究,并制定PPPSD临床诊疗系统及相应规范和标准,创建孕产妇心身健康门诊医疗服务模式,在全国不同民族与不同经济和文化特点地区的各级综合性医院围生保健中心或产科、妇幼保健院(中心)、社区卫生服务中心设立门诊研究基地,持续开展PPPSD相关全国多中心临床研究。总课题组自2015年制订《孕产期心身障碍临床路径》后,根据临床实践,不断进行修订、完善,并陆续发布2016修订版、2017修订版、2018修订版PPPSD临床路径。随着总课题组对PPPSD理论研究的不断深入,并结合全国多中心临床研究大样本数据的统计分析结果,再于《孕产期心身障碍临床路径(2018修订版)》基础上进行修订、完善,推出基于围生保健中心和产科的《孕产期心身障碍诊疗临床路径(2020修订版)》,为临床规范诊疗PPPSD提供标准。Under the bio-psycho-social medicine model,pregnancy and puerperium psychosomatic disorder(PPPSD)means physical dysfunction caused by either physiological,psychological and social factors or physiological and pathological risk factors,or jointly caused by the aforesaid factors.PPPSD can exert a significant impact on obstetric medical quality and do huge damage to the health of pregnant women,fetuses and newborns.The General Research Group of National Psychosomatic Health Clinic for Pregnancy and Puerperium(hereinafter referred to as"General Research Group")is devoted to researches of etiology,pathogenesis,diagnosis,treatment,prognosis,rehabilitation and other factors related to PPPSD,establishment of clinical diagnosis and treatment systems and relevant criteria and standards of PPPSD and establishment of clinical pregnancy physical and psychological health service patterns.Moreover,it is devoted to the establishment of outpatient research bases at perinatal care centers or obstetrics department in general hospitals at different levels,maternity and child care hospitals(centers),and community health service centers in different ethnic,economic and cultural regions of China,in order to carry out clinical studies of PPPSD.PPPSD clinical pathway was initially developed by the General Research Group in 2015 and then revised in 2016,2017 and 2018.With progress in theoretical studies,General Research Group revises the Clinical Pathway for Pregnancy and Puerperium Psychosomatic Disorder(2018 Revised Version)based on large-sample size analysis from numerous clinical research centers nationwide,and Clinical Pathway for Pregnancy and Puerperium Psychosomatic Disorder(2020 Revised Version)for perinatal period and obstetrics department is developed to standardize clinical diagnosis and treatment of PPPSD.

关 键 词：心理生理性障碍 躯体型障碍 精神障碍 焦虑 抑郁 临床路径 孕产妇 

分 类 号：R47[医药卫生—护理学]