中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
Chinese Journal of Anesthesiology
2015年
6期
674-676
,共3页
抑郁症,产后%氯胺酮
抑鬱癥,產後%氯胺酮
억욱증,산후%록알동
Depression,postpartum%Ketamine
目的 评价氯胺酮对剖宫产术患者产褥期抑郁症的预防效果.方法 拟行择期剖宫产术的患者120例,ASA分级Ⅰ级,年龄18~38岁,BMI<35 kg/m2,采用随机数字表法分为2组(n=60):对照组(C组)和氯胺酮组(K组).2组术毕时均采用舒芬太尼进行术后镇痛:舒芬太尼100 μg,用0.9%氯化钠注射液配至100 ml,输注速率2 ml/h,PCA剂量2 ml,锁定时间30 min,维持VAS评分<3分.K组镇痛泵中加入氯胺酮4 mg/kg.于术前及术后1、3、5和42 d时进行Edinburgh产后抑郁量表评分,总分≥13分诊断为产褥期抑郁症.记录产褥期抑郁症和K组术后3d内氯胺酮相关并发症的发生情况.结果 与C组比较,K组术后1、3和5d时Edinburgh产后抑量表评分降低,产褥期抑郁症发生率降低(P<0.05).K组未见氯胺酮相关并发症发生.结论 氯胺酮(术毕时开始静脉输注,持续48 h,总量4 mg/kg)对剖宫产术患者产褥期抑郁症有一定预防作用.
目的 評價氯胺酮對剖宮產術患者產褥期抑鬱癥的預防效果.方法 擬行擇期剖宮產術的患者120例,ASA分級Ⅰ級,年齡18~38歲,BMI<35 kg/m2,採用隨機數字錶法分為2組(n=60):對照組(C組)和氯胺酮組(K組).2組術畢時均採用舒芬太尼進行術後鎮痛:舒芬太尼100 μg,用0.9%氯化鈉註射液配至100 ml,輸註速率2 ml/h,PCA劑量2 ml,鎖定時間30 min,維持VAS評分<3分.K組鎮痛泵中加入氯胺酮4 mg/kg.于術前及術後1、3、5和42 d時進行Edinburgh產後抑鬱量錶評分,總分≥13分診斷為產褥期抑鬱癥.記錄產褥期抑鬱癥和K組術後3d內氯胺酮相關併髮癥的髮生情況.結果 與C組比較,K組術後1、3和5d時Edinburgh產後抑量錶評分降低,產褥期抑鬱癥髮生率降低(P<0.05).K組未見氯胺酮相關併髮癥髮生.結論 氯胺酮(術畢時開始靜脈輸註,持續48 h,總量4 mg/kg)對剖宮產術患者產褥期抑鬱癥有一定預防作用.
목적 평개록알동대부궁산술환자산욕기억욱증적예방효과.방법 의행택기부궁산술적환자120례,ASA분급Ⅰ급,년령18~38세,BMI<35 kg/m2,채용수궤수자표법분위2조(n=60):대조조(C조)화록알동조(K조).2조술필시균채용서분태니진행술후진통:서분태니100 μg,용0.9%록화납주사액배지100 ml,수주속솔2 ml/h,PCA제량2 ml,쇄정시간30 min,유지VAS평분<3분.K조진통빙중가입록알동4 mg/kg.우술전급술후1、3、5화42 d시진행Edinburgh산후억욱량표평분,총분≥13분진단위산욕기억욱증.기록산욕기억욱증화K조술후3d내록알동상관병발증적발생정황.결과 여C조비교,K조술후1、3화5d시Edinburgh산후억량표평분강저,산욕기억욱증발생솔강저(P<0.05).K조미견록알동상관병발증발생.결론 록알동(술필시개시정맥수주,지속48 h,총량4 mg/kg)대부궁산술환자산욕기억욱증유일정예방작용.
Objective To evaluate the efficacy of ketamine in preventing postpartum depression in patients undergoing cesarean section.Methods One hundred and twenty ASA physical status Ⅰ patieuts,aged 18-38 yr,with body mass index <35 kg/m2,scheduled for elective cesarean section,were equally and randomly divided into 2 groups using a random number table:control group (group C) and ketamine group (group K).Postoperative analgesia was performed with sufentanil 100 μg in 100 ml of normal saline,and sufentanil was infused at 2 ml/h (bolus dose 5 μg,lockout interval 15 min) in both groups.In group K,ketamine 4 mg/kg was added to analgesic pump.VAS score was maintained<3.Before surgery and at 1,3,5 and 42 days after surgery,depressive symptoms were measured using the Edinburgh Postpartum Depression Survey (EPDS),and postpartum depression was defined as EPDS score ≥ 13.Postpartum depression and ketamine-related complications occurred within 3 days after surgery in group K were recorded.Results Compared with group C,EPDS scores were significantly decreased at 1,3 and 5 days after surgery,and the incidence of postpartum depression was decreased in group K.Ketamine-related complications were not found in group K.Conclusion Ketamine (infused starting from the end of operation,lasting for 48 h,total amount 4 mg/kg) for postoperative analgesia can prevent postpartum depression to some extent in patients undergoing cesarean section.