产后抑郁症的发生及其干预措施

Occurrence and interventional measures of postpartum depression

目的:认识产后抑郁症的病因及干预措施,从而为临床工作及妊娠妇女卫生保健提供指导。资料来源:检索PubMed数据库1980-01/2007-04与产后抑郁症相关的文章,检索词为"postpartum depression,interference factor",限定语言种类为英语。同时以中文在CNKI数据库进行相关检索。资料选择:对资料进行初审,纳入与产后抑郁症发生相关的文献,排除重复性文献及非身心因素导致产后抑郁症发生文献。对剩余文献查找全文。资料提练:共收集到120篇关于产后抑郁症的文献,符合纳入标准34篇,排除涉及产后抑郁症实验室研究数据中包括神经递质及激素水平测定的文献86篇。资料综合:产后抑郁症的发生因素有:①生物学因素:包括内分泌、遗传、产科因素;②心理因素:成长经历的影响、人格特征、个人心理防御方式、病理心理机制的形成;③社会性因素:家庭类型因素、经济收入因素、年龄及受教育因素、社会支持因素、不良生活事件。产后抑郁症的干预措施有:①加强产妇卫生保健;②进行心理干预;③导乐分娩;④产后家庭随防。结论:针对产后抑郁症发生原因及特点,采取必要措施是可以有效预防及控制该病发生。

OBJECTIVE： To investigate the causes and interventional measures of postpartum depression, and to provide guidance for clinical work and the health care of parturient. DATA SOURCES： Articles dated between January 1980 and April 2007 with the keywords of ＂postpartum depression, interference factor＂ were searched in the computerized online databases of PubMed and CNKI. STUDY SELECTION： The data were selected firstly, and only those articles that contained information on postpartum depression were included, and repetitive articles and that about the postpartum depression caused by non-physical and mental factors were excluded. Additionally, the full-texts of the articles were looked up, DATA EXTRACTION： Among a total 120 articles that we obtained from the above-mentioned databases, 34 matched the inclusive criteria, and 86 involved the determination of neurotransmitter and hormone levels in the experimental study data of postpartum depression were excluded. DATA SYNTHESIS： There are many factors that could cause postpartum depression such as （1） biological factors including endocnne, heredity, and obstetrics; （2）psychological factors including growing experience, personality characteristics, patterns of individual psychological defense, and formation of pathopsychological mechanism; （3）social factors like family styles, income, age, education, social support, and bad events. The interventional measures for postpartum depression included （1）to strengthen the health care of parturient; （2）psychological intervention; （3）Doula accompany delivery; （4）postnatal family follow up, CONCLUSION： Appropriate measures could effectively prevent and control the occurrence of postpartum depression due to its causes and characteristics.