摘要
目的 探讨艾司氯胺酮对妊娠期疤痕子宫肥胖孕妇剖宫产舒适度和产后抑郁的影响。方法 选择宿迁市第一人民医院2022年6月至2024年2月腰麻下剖宫产生育二孩或三孩的妊娠期疤痕子宫肥胖孕妇88例为研究对象,使用随机数字表法随机分为对照组(n=44)和观察组(n=44)。在切皮前和腹腔探查前,观察组均推注0.2 mg/kg的艾司氯胺酮,对照组推注等量生理盐水,对两组孕妇的牵拉反应评分、疼痛程度、抑郁状况、血清同型半胱氨酸(Hcy)及母婴不良反应进行比较。结果 在剖宫取胎和关腹前腹腔探查时,观察组的牵拉反应评分[(1.85±0.41)分和(2.17±0.53)分]明显低于对照组[(3.03±0.54)分和(3.78±0.64)分](P<0.05),观察组的疼痛评分明显低于对照组(P<0.05);观察组的恶心呕吐发生率(4.55%)明显低于对照组(20.45%)(P<0.05);在术后1 d、3 d和7 d时点,观察组的Hcy均显著低于对照组(P<0.05);在术后1 d、3 d和7 d时点,观察组的抑郁评分[(4.65±1.32)分、(4.14±1.16)分和(3.81±1.02)分]均显著低于对照组[(5.74±1.56)分、(5.25±1.35)分和(4.56±1.23)分](P<0.05)。结论 艾司氯胺酮能够显著缓解妊娠期疤痕子宫肥胖孕妇剖宫产时的牵拉反应和疼痛程度,有利于提高孕妇术中舒适度,并改善产后抑郁状况,且母婴不良反应少。
Objective To explore the effects of esketamine on the comfort level of cesarean section and postpartum depression in obese pregnant women with scarred uterus.Methods A total of 88 obese pregnant women with scarred uterus who gave birth to their second or third child by cesarean section under lumbar anesthesia in the First People's Hospital of Suqian City from June 2022 to February 2024 were randomly divided into control group(n=44)and observation group(n=44)using a random number table method.Before incision and abdominal exploration,patients in observation group were injected with 0.2 mg/kg esketamine and patients in control group were injected with the same amount of normal saline.The scores of traction response,pain degree,maternal and infant adverse reactions,depression and serum Hcy of the two groups were compared.Results At the time points of cesarean section and abdominal exploration before abdominal closure,the traction response scores of observation group[(1.85±0.41)and(2.17±0.53)]were significantly lower than those of control group[(3.03±0.54)and(3.78±0.64)](P<0.05),and the pain scores of observation group were significantly lower than those of control group(P<0.05).The incidence of nausea and vomiting in observation group(4.55%)was significantly lower than that in control group(20.45%)(P<0.05).At 1 d,3 d and 7 d after surgery,the depression scores of observation group[(4.65±1.32),(4.14±1.16)and(3.81±1.02)]were significantly lower than those of control group[(5.74±1.56),(5.25±1.35)and(4.56±1.23)](P<0.05).At 1 d,3 d and 7 d after surgery,the Hcy level of observation group was significantly lower than that of control group(P<0.05).Conclusion Esketamine can significantly alleviate the pull reaction and pain degree during cesarean section of obese pregnant women with scar uterus,which is conducive to improving the comfort level during surgery and postpartum depression,and the adverse reactions of mother and child are less.
作者
许旭
陆璇
吴浩
徐幻浠
李先蕊
Xu Xu;Lu Xuan;Wu Hao;Xu Huanxi;Li Xianrui(Department of Anesthesiology and Perioperative Medicine,Suqian Hospital of Jiangsu Provincial People's Hospital,Suqian 223800,China)
出处
《实用药物与临床》
CAS
2024年第12期904-908,共5页
Practical Pharmacy and Clinical Remedies
基金
江苏省妇幼健康科研项目(F2020066)。
关键词
艾司氯胺酮
妊娠期肥胖
疤痕子宫
舒适度
产后抑郁
Esketamine
Obesity in pregnancy
Scarred uterus
Comfort level
Postpartum depression
