雌激素 心理防御评分及胃肠功能与剖宫产产妇产后抑郁的相关性和危险因素分析  

The Correlation and risk factors of estrogen, psychological defense score, gastrointestinal function and postpartum depression in cesarean section

作　　者：胡燮军 王乐乐[2] 甘建光 HU Xie-Jun;WANG Le-Le;GAN Jian-Guang(The Second Department of Psychiatry,the Seventh People's Hospital of Shaoxing,Shaoxing,Zhejang 3i2000,China)

机构地区：[1]绍兴市第七人民医院精神二科,浙江绍兴312000 [2]绍兴市妇幼保健院产科五区,浙江绍兴312000

出　　处：《中国妇幼保健》2022年第22期4250-4254,共5页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2020ZH058)。

摘　　要：目的 探讨雌激素、心理防御评分、胃肠功能与剖宫产产妇产后抑郁的相关性及危险因素。方法 选择2018年1月-2019年12月绍兴市第七人民医院收治的103例爱丁堡产后抑郁评分(EPDS)9/10分的剖宫产产妇为研究对象,纳入观察组(CG);选择同期103例EPDS<9分的产妇进行对比,纳入对照组(IG)。对比各组雌激素、心理防御评分及胃肠功能指标,找出剖宫产产后抑郁发病的危险因素,并对所有危险因素进行logistic分析。结果 与组内相比,CG组患者产后雌二醇(63.22±0.32)pmol/L、孕酮(0.11±0.04)ng/L及PRL水平(0.10±0.02)ng/L均较产前[(125.32±0.16)pmol/L、(0.22±0.08)ng/L、(0.23±0.01)ng/L]显著下降(P<0.05),IG组产后雌二醇(102.23±0.19)pmol/L、PRL水平(0.32±0.03)ng/L均较产前[(124.11±0.12)pmol/L、(3.12±0.03)ng/L]显著下降(P<0.05),孕酮[(0.24±0.09)ng/L、(0.28±0.03)ng/L]则未出现显著变化(P>0.05);CG组与IG组两组患者产后7 d的GSRS评分[(88.31±0.62)分、(17.12±0.51)分]显著均高于产前1 d水平[(14.12±0.17)分、(14.43±0.14)分],产后7 d胃泌素水平[(282.23±0.27)ng/L、(342.53±0.19)ng/L]则均显著低于产前1 d水平[(342.03±0.31)ng/L、(372.12±0.41)ng/L](P<0.05);组间相比,产前1 d的IG、CG两组的雌性激素水平、GSRS、胃泌量差异无统计学意义(P>0.05),产后7 d的CG组的雌二醇(63.22±0.32)pmol/L、孕酮(0.11±0.04)ng/L、催乳素(0.10±0.02)ng/L及胃泌量(282.23±0.27)ng/L显著低于IG组[(102.23±0.19)pmol/L、(0.28±0.03)ng/L、(0.32±0.03)ng/L、(342.53±0.19)ng/L],而GSRS评分(88.31±0.62)分、成熟防御机制(4.22±0.04)分、抱怨与退缩(9.21±0.02)分、躯体化(6.13±0.02)分、被动攻击与消耗评分(6.12±0.12)分及PDSQ总分(38.21±0.23)分和肠梗阻发生率(14.6%)高于IG组[(17.12±0.51)分、(5.23±0.24)分、(7.22±0.03)分、(3.02±0.01)分、(3.12±0.24)分、(27.32±0.32)分、3.9%],肠鸣恢复时间(4.02±0.32)d、首次排便时间(5.02±0.13)d长于IG组[(1.13±0.12)d、(1.28Objective to explore the correlation and risk factors of estrogen, psychological defense score, gastrointestinal function and postpartum depression in cesarean section.Methods 103 cases of cesarean section women with 9/10 Edinburgh Postpartum Depression Scale(EPDS) from January 2018 to December 2019 in the Department of Obstetrics and gynecology were selected as the research objects and included in the observation group(CG);to choice103 pregnant women with EPDS<9 points were selected in the same period and included in the control group(IG).the risk factors of postpartum depression after cesarean section were found out by comparing the estrogen, psychological defense score and gastrointestinal function indexes of each group, and all the risk factors were analyzed by logistic analysis.Results The levels of estradiol(63.22±0.32)pmol/L, progesterone(0.11±0.04)ng/L and PRL(0.10±0.02)ng/L in CG group were significantly decreased compared with prenatal [(125.32±0.16)pmol/L,(0.22±0.08)ng/L,(0.23±0.01)ng/L](P<0.05)and the levels of estradiol(102.23±0.19)pmol/Land PRL(0.32±0.03)ng/L in IG group were significantly decreased compared with prenatal[(124.11±0.12)pmol/L,(3.12±0.03)ng/L](P<0.05), while progesterone[(0.24±0.09)ng/L,(0.28±0.03)ng/L] was no significantly changed. GSRS scores[(88.31±0.62),(17.12±0.51)] of patients in CG group and IG group on the 7 d after delivery were significantly higher than those on the 1 d [(14.12±0.17),(14.43±0.14)] before delivery, while gastrin levels [(282.23±0.27)ng/L,(342.53±0.19)ng/L]on the 7 th day after delivery were significantly lower than those on the 1 d [(342.03±0.31)ng/L,(372.12±0.41)ng/L] before delivery(P<0.05). Comparison between CG and IG groups, there was no significant difference in the levels of estrogen, GSRS and gastric secretion between the two groups on the 1 st day before delivery(P>0.05). The levels of estradiol(63.22±0.32)pmol/L, progesterone(0.11±0.04)ng/L, prolactin(0.10±0.02)ng/L and gastric(282.23±0.27)ng/L secretion in CG group [(102.23�

关 键 词：雌性激素 心理防御评分 胃肠道症状积分 剖宫产 产后抑郁 

分 类 号：R714[医药卫生—妇产科学]