鞘内注射氯胺酮预防剖宫产术后产后抑郁的研究
A Study on the Preventive Effect of Esketamine on Postpartum Depression (PPD) after Cesarean Section.
机构信息
Department of Anesthesiology, The Fourth Hospital of Shijiazhuang, Shijiazhuang, 050000 Hebei, China.
Department of Anesthesiology, The Eighth Hospital of Shijiazhuang, Shijiazhuang, 050000 Hebei, China.
出版信息
Comput Math Methods Med. 2022 Aug 8;2022:1524198. doi: 10.1155/2022/1524198. eCollection 2022.
OBJECTIVE
The purpose of this study is to explore and analyze the preventive effect of esketamine on postpartum depression (PPD) after cesarean section.
METHODS
A total of 138 puerperae who underwent cesarean section in our hospital from February 2020 to January 2022 were selected as the research subjects. The control group was given intravenous injection of 2 ml of normal saline after the fetus was delivered. Meanwhile, the observation group was given intravenous injection of a small dose of esketamine (esketamine 0.5 mg/kg+ 2 ml of normal saline) after the delivery of the fetus. The changes of blood pressure and heart rate, the Edinburgh Postnatal Depression Scale (EPDS) questionnaire scores and the incidence of postpartum depression were compared between the two groups. At the same time, the incidence of postoperative adverse events in the two groups was observed.
RESULTS
There was no significant difference in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) between the two groups at T1-T3 ( > 0.05). Compared with the control group, the SBP, DBP, and HR at T4 and T5 in the observation group were higher ( < 0.05). There was no significant difference in SBP, DBP, and HR at T3, T4, and T5 in the observation group ( > 0.05). Compared with T3, SBP, DBP, and HR were lower in control group T4 and T5, respectively. There was no significant difference in the EPDS scores between the two groups on the 1st day before delivery ( > 0.05). The EPDS scores of the two groups were higher at 3d postpartum and 42d postpartum, respectively, than at 1d before delivery. The EPDS scores of the observation group at 3d and 42d after delivery were lower than those in the control group ( < 0.05). Compared with the control group, the incidence of postpartum depression was higher in the observation group at 3 days postpartum and 1 month postpartum, respectively ( < 0.05). There was no significant difference in the incidence of postpartum adverse reactions between the two groups ( > 0.05).
CONCLUSION
The application of esketamine after cesarean section can effectively reduce depression-related scores and the risk of postpartum depression without increasing adverse reactions and has high safety.
目的
本研究旨在探讨和分析氯胺酮对剖宫产术后产后抑郁症（PPD）的预防作用。
方法
选取 2020 年 2 月至 2022 年 1 月在我院行剖宫产的 138 例产妇为研究对象，对照组胎儿娩出后给予静脉注射 2ml 生理盐水，观察组胎儿娩出后给予小剂量氯胺酮（氯胺酮 0.5mg/kg+2ml 生理盐水）静脉注射。比较两组产妇血压和心率变化、爱丁堡产后抑郁量表（EPDS）问卷评分及产后抑郁发生率，同时观察两组产妇术后不良反应发生情况。
结果
两组产妇 T1-T3 时的收缩压（SBP）、舒张压（DBP）和心率（HR）比较，差异无统计学意义（>0.05）；观察组产妇 T4、T5 时的 SBP、DBP 和 HR 均高于对照组（<0.05）；观察组产妇 T3、T4、T5 时的 SBP、DBP 和 HR 比较，差异无统计学意义（>0.05）。两组产妇分娩前 1d 的 EPDS 评分比较，差异无统计学意义（>0.05）；两组产妇产后 3d 和 42d 的 EPDS 评分均高于分娩前 1d，观察组产妇产后 3d 和 42d 的 EPDS 评分均低于对照组（<0.05）。观察组产妇产后 3d 和 1 个月的产后抑郁发生率均高于对照组（<0.05）；两组产妇产后不良反应发生率比较，差异无统计学意义（>0.05）。
结论
剖宫产术后应用氯胺酮可有效降低抑郁相关评分和产后抑郁风险，且不增加不良反应，安全性高。
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