艾司氯胺酮对腹腔镜宫外孕手术患者术后抑郁、焦虑、疼痛的影响及安全性研究  

The effect and safety of esmketamine on postoperative depression,anxiety and pain in patients undergoing laparoscopic ectopic pregnancy surgery

作　　者：金亮 涂泽华 苟玉元 JIN Liang;TU Zehua;GOU Yuyuan(Zhongshan Xiaolan People’s Hospital,Zhongshan 528415,China;Yunnan Provincial Yongshan County Peoples Hospital,Yongshan 657300,China)

机构地区：[1]中山市小榄人民医院,广东中山528415 [2]云南省永善县人民医院,云南永善657300

出　　处：《广东药科大学学报》2024年第3期106-111,共6页Journal of Guangdong Pharmaceutical University

基　　金：中山市医学科研项目(2021A020347)。

摘　　要：目的探讨艾司氯胺酮对腹腔镜宫外孕手术患者术后抑郁、焦虑、疼痛的影响及安全性。方法选取2022年1月至2023年7月在中山市小榄人民医院行腹腔镜宫外孕手术患者152例,根据随机数字表法分为观察组、对照组,各76例。比较2组患者术后抑郁症状[抑郁自评量表(SDS)]、焦虑症状[焦虑自评量表(SAS)]、疼痛情况[视觉模拟评分法(VAS)]、安全性;并分析术后抑郁症状的影响因素。结果术后3 d,2组患者SDS评分均增高,但观察组低于对照组(P<0.05),术前术后差值观察组也低于对照组(P<0.05)。术后3 d,2组SAS评分均降低,观察组低于对照组(P<0.05),术前术后差值观察组高于对照组(P<0.05)。术后6、12、24 h,观察组VAS评分均低于对照组(P<0.05)。2组患者恶心、呕吐、头晕头痛、寒战、躁动发生率比较,差异无统计学意义(P>0.05)。线性回归分析显示,术前焦虑(β=0.334,95%CI=0.099~0.569)、术后6 h疼痛评分(β=3.152,95%CI=1.280~5.024)是宫外孕患者术后抑郁的危险因素(P<0.05),艾司氯胺酮方案(β=-2.806,95%CI=-4.861~-0.751)是宫外孕患者术后抑郁的保护因素(P<0.05)。结论腹腔镜宫外孕术中应用艾司氯胺酮可改善术后抑郁症状,且不增加不良反应,安全可靠;术前焦虑、术后6 h疼痛会增加术后抑郁风险,而艾司氯胺酮方案可减轻焦虑与疼痛。Objective To investigate the effect and safety of esmketamine on postoperative depression,anxiety and pain in patients undergoing laparoscopic ectopic pregnancy surgery.Methods A total of 152 patients who underwent laparoscopic ectopic pregnancy surgery in Zhongshan Xiaolan People's Hospital from January 2022 to July 2023 were selected and divided into an observation group and a control group according to the random number table method,with 76 cases in each group.The postoperative depression symptoms[self-rating depression scale(SDS)],anxiety symptoms[self-rating anxiety scale(SAS)],pain[visual analogue scale(VAS)]and safety were compared between the two groups.The influencing factors of postoperative depressive symptoms were analyzed.Results Three days after operation,the SDS scores of the two groups increased,but the SDS scores of the observation group were lower than those of the control group(P<0.05).The difference between the preoperative and postoperative SDS scores of the observation group was also lower than that of the control group(P<0.05).Three days after operation,SAS scores of the two groups decreased,and SAS scores of the observation group were lower than those of the control group(P<0.05).The difference between preoperative and postoperative SAS scores of the observation group was higher than that of the control group(P<0.05).The VAS scores of the observation group were lower tthose of the control group at 6 h,12 h and 24 h after operation(P<0.05).There was no statistically significant difference in the incidence of nausea,vomiting,dizziness,headache,chills and restlessness between the two groups(P>0.05).Linear regression analysis showed that Preoperative anxiety(β=0.334,95%CI=0.099-0.569)and 6h postoperative pain score(β=3.152,95%CI=1.280-5.024)were risk factors for postoperative depression in ectopic pregnancy patients(P<0.05).Esketamine regimen(β=-2.806,95%CI=-4.861--0.751)was a protective factor for postoperative depression in ectopic pregnancy patients(P<0.05).Conclusions The application of

关 键 词：宫外孕 艾司氯胺酮 术后抑郁 焦虑 疼痛 

分 类 号：R714.2205[医药卫生—妇产科学]