硬膜外分娩镇痛对产后抑郁症影响的临床研究

发布时间：2018-08-24 15:39

【摘要】：目的:研究硬膜外分娩镇痛与降低产后抑郁症的发病风险是否相关。方法:根据纳入排除标准及自愿参加本项研究原则,选择符合条件的初产妇212人,按照是否自愿选择硬膜外分娩镇痛将其分为两组,其中非镇痛组113人,镇痛组99人。记录两组初产妇不同时间点的数字疼痛评分(NRS)、舒适满意度等围产期相关变量,并于产后第3天和第42天分别行爱丁堡产后抑郁量表评分(EPDS)调查,记录产后抑郁症(PPD)发生情况。结果:最终有35名初产妇由于各种原因没有完成整项研究,故有177人被包含在最终的数据分析中,其中非镇痛组92人,镇痛组85人。产后抑郁症的发生率在接受硬膜外镇痛组和非镇痛组中分别为14.12%(85人有12人)和29.35%(92人有27人)(P=0.015)。使用硬膜外分娩镇痛与产后抑郁症的风险降低二者相关(OR 0.396,95%CI,0.185-0.844,P0.05),且产后3天和42天的EPDS评分之间存有相关性(Spearman相关系数=0.543,P0.001)。结论:硬膜外分娩镇痛与降低产后抑郁症的发生确实相关,但仍需进一步扩大样本量证实二者关联的相关具体原因。
[Abstract]:Objective: to study whether epidural labor analgesia is associated with reducing the risk of postpartum depression. Methods: according to the principle of exclusion and voluntary participation, 212 primipara were selected and divided into two groups according to their voluntary choice of epidural labor analgesia, including 113 patients in non-analgesia group and 99 patients in analgesia group. Perinatal variables such as (NRS), comfort satisfaction were recorded at different time points of puerpera in two groups. (EPDS) survey was performed on the 3rd and 42nd postpartum, respectively, to record the incidence of (PPD) in postpartum depression. Results: the final 35 primipara did not complete the whole study for various reasons, so 177 were included in the final data analysis, including 92 patients in non-analgesic group and 85 in analgesia group. The incidence of postpartum depression was 14.12% in epidural analgesia group and 29.35% in non-analgesia group (P 0.015). Epidural labor analgesia was associated with a reduced risk of postpartum depression (OR 0.396C95), and there was a correlation between the EPDS scores of 3 and 42 days postpartum (Spearman correlation coefficient 0.543p0.001). Conclusion: epidural labor analgesia is associated with the reduction of postpartum depression, but it is still necessary to further expand the sample size to confirm the specific causes of the correlation between epidural analgesia and postpartum depression.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.3

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