艾司氯胺酮小剂量预注对剖宫产术产妇的影响

Effect of Low Dose Esketamine Pre-injection on Parturients undergoing Cesarean Section

目的:探讨艾司氯胺酮小剂量预注对剖宫产术产妇的影响。方法:选取2021年1月—2022年1月驻马店市中医院收治的行剖宫产术产妇240例为观察对象,采用随机数字表法分为对照组(预注生理盐水)及观察组(预注0.5 mg/kg艾司氯胺酮),各120例。比较两组产妇抑郁缓解情况[爱丁堡产后抑郁量表(EPDS)评分]、生命体征指标、应激反应指标、不良反应发生率、生活质量[生活质量评定量表(SF-36)]。结果:产后2、5、7 d,观察组EPDS评分低于对照组,差异有统计学意义(P<0.001);产后48 h,观察组收缩压、舒张压、心率高于对照组,差异有统计学意义(P<0.05);观察组去甲肾上腺素、心钠素、血浆肾上腺素及血清皮质醇水平低于对照组,差异有统计学意义(P<0.001);观察组SF-36评分高于对照组,差异有统计学意义(P<0.001)。结论:剖宫产术期间实施艾司氯胺酮小剂量预注可改善产妇产后抑郁情况,保障产妇产后生活质量,降低应激反应,保障生命体征平稳。

Objective:To investigate the effect of low dose esketamine pre-injection on parturients undergoing cesarean section.Methods:A total of two hundred and forty women who underwent cesarean section in Zhumadian Hospital of Traditional Chinese Medicine from January 2021 to January 2022 were selected as the observation objects,and were divided into control group(pre-injection of normal saline)and observation group(pre-injection of 0.5 mg/kg esketamine)by random number table method,with one hundred and twenty cases in each group.The remission of maternal depression[edinburgh postpartum depression scale(EPDS)score],vital signs indicators,stress response indicators,incidence of adverse reactions,and quality of life[SF-36]of the two groups were compared.Results:At 2,5 and 7 days postpartum,EPDS scores in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.001);48 h after delivery,systolic blood pressure,diastolic blood pressure and heart rate in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05);The levels of norepinephrine,atrial natriuretic hormone,plasma epinephrine and serum cortisol in observation group were lower than those in control group,and the differences were statistically significant(P<0.001);The SF-36 score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.001).Conclusion:Small dose of esketamine pre-injection during cesarean section can improve postpartum depression,guarantee postpartum quality of life,reduce stress reaction and ensure stable vital signs.