经皮穴位电刺激对睡眠障碍孕产妇剖宫产术后睡眠质量及产后抑郁的影响  

Effect of transcutaneous electrical acupoint stimulation on sleep quality after cesarean section and postpartum depression in parturients with sleep disorders

作　　者：何锟[1] 韩霜[2] 张丽 张瑾[1] 李雅楠 He Kun;Han Shuang;Zhang Li;Zhang Jin;Li Ya′nan(Department of Anesthesiology,Shijiazhuang Fourth Hospital,Shijiazhuang 050000,China;Department of Anesthesiology,Hebei General Hospital,Shijiazhuang 050000,China;Department of Anesthesiology,Shexian Hospital,Handan 056400,China)

机构地区：[1]石家庄市第四医院麻醉科,050000 [2]河北省人民医院麻醉科,石家庄050000 [3]邯郸市涉县医院麻醉科,056400

出　　处：《中华麻醉学杂志》2021年第8期946-950,共5页Chinese Journal of Anesthesiology

摘　　要：目的评价经皮穴位电刺激对睡眠障碍孕产妇剖宫产术后睡眠质量及产后抑郁的影响。方法择期剖宫产术孕产妇225例,年龄20~45岁,体重50~80 kg,ASA分级Ⅰ或Ⅱ级。术前采用匹兹堡睡眠质量指数量表(PSQI)进行睡眠质量调查,PSQI评分<7分无睡眠障碍组(NSD组)(n=76);PSQI评分≥7分为睡眠障碍,采用随机数字表法分为睡眠障碍组(SD组,n=73)和经皮穴位电刺激组(TEAS组,n=76)。NSD组和SD组行常规腰硬联合麻醉;TEAS组于腰硬联合麻醉完成后至术毕,选取内关、百会、足三里、三阴交穴行经皮穴位电刺激,于术后第1和2天进行经皮穴位电刺激30 min,3组术后均采用自控静脉镇痛。分别于术前、术后1和2 d时取肘静脉血,采用ELISA法测定血浆褪黑素及泌乳素浓度;术前、术后1、2和7 d时采用里兹睡眠问卷(LSEQ)评分评估睡眠质量;于术后6周时采用爱丁堡产后抑郁评分(EPDS)进行产后抑郁评分。结果与NSD组比较,SD组术后各时点LSEQ评分降低,产后抑郁发生率升高,血浆褪黑素及泌乳素浓度降低,泌乳启动时间延长(P<0.05);与SD组比较,TEAS组术后各时点LSEQ评分升高,产后抑郁发生率降低,血浆褪黑素和泌乳素浓度升高,泌乳启动时间缩短(P<0.05)。结论经皮穴位电刺激可提高睡眠障碍孕产妇剖宫产术后睡眠质量,减少产后抑郁发生。Objective To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)on the sleep quality after cesarean section and postpartum depression in parturients with sleep disorder.Methods A total of 225 parturients,aged 20-45 yr,weighing 50-80 kg,of American Society of Anesthesiologists physical statusⅠorⅡ,scheduled for elective cesarean section,were enrolled in this study.The Pittsburgh Sleep Quality Index(PSQI)scale was used to investigate the sleep quality before operation.PSQI score<7 was defined as having no sleep disorder,and the patients were included in the non-sleep disorder group(NSD group,n=76).PSQI score≥7 was defined as having sleep disorder,and the patients were randomly divided into sleep disorder group(SD group,n=73)and TEAS group(n=76).Routine combined spinal-epidural anesthesia was performed in NSD group and SD group.In TEAS group,Neiguan,Baihui,Zusanli and Sanyinjiao acupoints were selected for performing TEAS from the completion of combined spinal-epidural anesthesia to the end of operation,and TEAS was performed for 30 min on the 1st and 2nd days after operation.Patient-controlled intravenous analgesia was applied after operation in the three groups.The blood samples were taken from the cubital vein before operation and at 1 and 2 days after operation for determination of the plasma melatonin and prolactin concentrations(by enzyme-linked immunosorbent assay).The Leeds Sleep Evaluation Questionnaire(LSEQ)was used to evaluate the quality of sleep before operation and at 1,2 and 7 days after operation.The Edinburgh Postpartum Depression Scale was used to evaluate the postpartum depression at 6 weeks after operation.Results Compared with NSD group,LSEQ scores were significantly decreased at each time point after operation,the incidence of postpartum depression was increased,and the concentrations of plasma melatonin and prolactin were decreased,and the lactation initiation time was prolonged in SD group(P<0.05).Compared with SD group,LSEQ scores were significantly increased at

关 键 词：电刺激疗法 入睡和睡眠障碍 剖宫产术 抑郁症 产后 

分 类 号：R614[医药卫生—麻醉学]