椎管内分娩镇痛对产时焦虑/抑郁情绪障碍的影响

Effect of intraspinal labor analgesia on intrapartum anxiety/depression emotional disorders

目的探讨椎管内分娩镇痛对产时焦虑/抑郁情绪障碍的影响。方法选择阴道分娩的120名初产妇作为研究对象,其中镇痛组孕产妇55名,非镇痛组孕产妇47名,18名孕产妇因中转为剖宫产或产时失访被排除在外,分别于第一产程(潜伏期、活跃期)、第二产程以及第三产程对其进行面对面问卷调查(包括孕产妇人口统计学、社会经济学资料和标准化的疼痛程度数字评定量表、焦虑自评量表、爱丁堡产后抑郁量表),比较2组中重度疼痛所占比例、焦虑/抑郁情绪障碍的发生率。结果镇痛组第一产程(潜伏期、活跃期)、第二产程的中重度疼痛所占比例均低于非镇痛组(P均<0.001)。镇痛组在活跃期、第二产程的焦虑情绪障碍发生率及第二产程中抑郁情绪障碍的发生率均低于非镇痛组(P均<0.05)。结论椎管内分娩镇痛可以缓解孕产妇产时的焦虑及抑郁情绪。

Objective To investigate the effect of intraspinal labor analgesia on intrapartum anxiety/depression emotional disorders. Methods A total of 120 primiparae who delivered vaginally were selected as subjects, including 55 in the analgesia group, 47 in the non-analgesia group, and 18 pregnant women were excluded due to switching to cesarean section or intrapartum lost to follow-up. Face-to-face questionnaires were conducted at the first stage of labor(incubation period, active period), the second, and the third stages of labor(including maternal demography, socioeconomic data, and standardized numerical pain rating scale, self-rating anxiety scale, and the Edinburgh postpartum depression scale). The proportion of moderate to severe pain and the incidence of anxiety/depression emotional disorders were compared between the two groups. Results The proportion of moderate and severe pain in the first(incubation period, active period) and second stage of labor in the analgesia group was lower than that in the non-analgesia group(all P < 0.001). The incidence of anxiety disorders in the active stage and the second stage of labor, and the incidence of depression disorders in the second stage of labor were lower in the analgesic group than in the non-analgesic group, and the differences were statistically significant(all P < 0.05). Conclusion Intraspinal labor analgesia can relieve maternal anxiety and depression during childbirth.