艾司氯胺酮对剖宫产产妇产后抑郁的影响  

The Effect of Escitalopram on Postpartum Depression in Cesarean Delivery Mothers

作　　者：王明玉[1] 衡垒 WANG Mingyu;HENG Lei(Department of Anesthesiology,Xuzhou Maternal and Child Health Hospital,Xuzhou,Jiangsu Province,221000 China;Department of Anesthesiology,Xuzhou Cancer Hospital,Xuzhou,Jiangsu Province,221000 China)

机构地区：[1]徐州市妇幼保健院麻醉科,江苏徐州221000 [2]徐州市肿瘤医院麻醉科,江苏徐州221000

出　　处：《中外医疗》2023年第20期114-117,共4页China & Foreign Medical Treatment

基　　金：徐州市科技重点研发计划(农业与社会发展)(KC19148)。

摘　　要：目的 分析予以剖宫产产妇艾司氯胺酮治疗的临床价值。方法 随机选择2020年5月—2022年5月徐州市妇幼保健院接收的90例择期行剖宫产手术产妇为研究对象,根据切断脐带后使用艾司氯胺酮的情况将其分为3组,每组30例。不使用艾司氯胺酮者为C组,高剂量(0.3 mg/kg)艾司氯胺酮者为K1组,小剂量(0.15 mg/kg)艾司氯胺酮者为K2组。对比3组产妇爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale,EPDS)评分、疼痛视觉模拟评分(Visual Analog Scale,VAS)、应激指标及不良反应。结果 术前1 h、术后4周,3组EPDS评分比较,差异无统计学意义(P>0.05)。术后24 h、术后4 d,K2组EPDS评分低于K1组、C组,差异有统计学意义(P<0.05)。术后6、12 h,K2组VAS评分为(2.89±0.75)分、(2.91±0.81)分,低于K1组、C组的(2.98±0.87)分、(2.96±0.74)分、(3.79±1.12)分、(3.45±0.71)分,差异有统计学意义(F=8.592、4.692,P<0.05)。术后4周,3组VAS评分比较,差异无统计学意义(P>0.05)。各时刻,3组SBP、DBP、MAP水平比较,差异无统计学意义(P>0.05)。3组不良反应发生率分别为46.67%、50.00%、43.33%,差异无统计学意义(P>0.05)。结论 予以剖宫产产妇0.15 mg/kg剂量的艾司氯胺酮治疗能够减轻产妇产后短期内的抑郁程度,并缓解产妇产后疼痛感,且产妇生命体征稳定。Objective To analyze the clinical value of treating cesarean section mothers with escitalopram.Methods A total of 90 women receiving elective cesarean section in Xuzhou Maternal and Child Health Hospital from May 2020 to May 2022 were randomly selected as the study objects,and were divided into 3 groups according to the use of esketamine after umbilical cord cutting,with 30 cases in each group.Those who did not use esketamine were in group C,those with high dose(0.3 mg/kg)esketamine were in group K1,and those with low dose(0.15 mg/kg)Esketamine were in group K2.The Edinburgh Postnatal Depression Scale(EPDS)score,Visual Analog Scale(VAS)score,stress index and adverse reactions were compared between the three groups.Results There was no statistically significant difference in EPDS scores among 3 groups 1 h before surgery and 4 weeks after surgery(P>0.05).24 h and 4 d after surgery,EPDS scores in K2 group were lower than those in K1 group and C group,and the difference was statistically significant(P<0.05).At 6 and 12 h after surgery,VAS scores of K2 group were(2.89±0.75)points and(2.91±0.81)points,which were lower than those of K1 group and C group(2.98±0.87)points,(2.96±0.74)points,(3.79±1.12)points and(3.45±0.71)points,and the difference was statistically significant(F=8.592,4.692,P<0.05).At 4 weeks after operation,there was no statistically significant difference in VAS scores among 3 groups(P>0.05).There was no statistically significant difference in the levels of SBP,DBP and MAP among the three groups(P>0.05).The incidence of adverse reactions in 3 groups was 46.67%,50.00%,43.33%,respectively,and the difference was no statistically significant(P>0.05).Conclusion 0.15 mg/kg esketamine treatment in cesarean section can reduce the degree of depression and pain in the postpartum period,and the vital signs of the mothers are stable.

关 键 词：剖宫产 产妇 艾司氯胺酮 产后抑郁 疼痛程度 不良反应 

分 类 号：R749[医药卫生—神经病学与精神病学]