产妇心理与分娩方式及分娩过程的关系  

Relationship between Psychological Factors and Mode or Duration of Labor

作　　者：匡军秀[1] 魏敏[1] 白骏[1] 

机构地区：[1]武汉大学人民医院妇产科,430060

出　　处：《中华围产医学杂志》2003年第1期3-5,共3页Chinese Journal of Perinatal Medicine

摘　　要：目的　观察产妇精神状态 (焦虑及抑郁 )与分娩方式、分娩过程及产后出血的关系。　方法　 92例健康无剖宫产指征的单胎初产妇 ,以焦虑自评量表 (SAS)及抑郁自评量表 (SDS)评定精神状态 ,按均分划分 SAS、SDS高分组及低分组。所有产妇以产科常规进行分娩而不进行干预 ,观察其分娩方式、产程及产后出血情况。　结果　 (1) 92例产妇中顺产 80例 ,其中有 8例发生产后出血。(2 )中学文化程度组较大学文化程度组、顺产组较难产组、无产后出血组较产后出血组的 SAS、SDS评分均要低 ,各组间 SAS评分比较的 t值分别为 3.72、3.75、3.0 8,差异有非常显著性 (P<0 .0 1) ,SDS评分比较的 t值分别为 4.0 6 (P<0 .0 1)、2 .5 (P<0 .0 5 )、2 .6 2 (P<0 .0 5 ) ,差异亦有显著性。而SAS高分组产妇的第一、第二产程均较 SAS低分组要长 ,t值分别为 6 .5 3、5 .41,差异有非常显著性(P<0 .0 1)。同样 ,SDS高分组较 SDS低分组产妇的第一、第二产程也要延长 ,t值分别为 3.6 9、2 .6 8,差异亦有非常显著性 (P<0 .0 1)。　结论　焦虑及抑郁状态可增加难产及产后出血的发生率。故可提供有针对性的心理干预以提高产科质量。Objective To observe the relationship between psychological factor(anxiety and depression) and postpartum hemorrhage?mode and duration of labor. Methods Ninety two healthy nulliparas who had no gist of cesarean section were involved in our study. Their psychosis were evaluated with Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS),according to which they were divided into two groups:high-score group and low-score group.All women were not interfered during the courses of delivery. Mode, duration of labor and postpartum hemorrhage were observed. Results Among the 92 nulliparas observed, the spontaneous delivery rate was 86.96% (80 cases) and the postpartum hemorrhage rate was 10% (8 cases). The scores of SAS and SDS of the low educational level group, the spontaneous group or the non-hemorrhage group were significantly lower than those of the high educational level group, the dystocia group or the hemorrhage group respectively. Moreover, the duration of first and the second stage of the high SAS score group or the high SDS score group was significantly longer than that of the low SAS score group or the low SDS score group,P<0.01. Conclusions The statue of anxiety and depression may increase the rate of dystocia and postpartum hemorrhage. So it is suggested that the aimed psychological education is beneficial to improve the quality of obstetrics.

关 键 词：焦虑 抑郁症 心理干预 产妇心理 分娩方式 分娩过程 

分 类 号：R714.3[医药卫生—妇产科学] R395.6[医药卫生—临床医学]