摘要
目的 探讨术中使用亚麻醉剂量氯胺酮对剖宫产术后抗抑郁的作用.方法 将126例剖宫产产妇按术中是否应用氯胺酮分为氯胺酮组和对照组,每组63例,对照组产妇在胎儿娩出后静脉滴注0.9%氯化钠20 ml,氯胺酮组产妇在胎儿娩出后静脉滴注亚麻醉剂量氯胺酮（0.5 mg/kg加入20 ml 0.9%氯化钠）.分别采用医院焦虑抑郁量表（HADS）和产后抑郁筛查量表（PDSS）对产妇进行评估.结果 氯胺酮组产后5和10 d HADS和PDSS评分均明显低于对照组[HADS：（7.67±2.53）分比（10.48±2.48）分和（7.96±2.61）分比（11.24±2.74）分,PDSS：（52.58±13.36）分比（71.34±15.19）分和（53.73±13.28）分比（73.41±15.37）分],差异有统计学意义（P〈0.01）.氯胺酮组产后5和10 d抑郁发生率明显低于对照组[4.8%（3/63）比15.9%（10/63）和4.8%（3/63）比17.5%（11/63）],差异有统计学意义（P〈0.05）.两组产妇均无严重不良反应发生,仅对照组有2例发生轻度恶心,经调整后症状消失.结论 术中使用亚麻醉剂量氯胺酮能够明显降低剖宫产产妇术后抑郁的发生率,具有良好的抗抑郁效果.
Objective To study the antidepressant effect of subanesthestic dose ketamine in anesthesia after cesarean section. Methods One hundred and twenty-six parturients who had underwent cesarean section were divided into ketamine group and control group with 63 cases each, The parturients in control group were given intravenous 0.9%sodium chloride 20 ml after childbirth, and the parturients in ketamine group were given subanesthetic dose ketamine after childbirth （0.5 mg/kg ＋ 20 ml 0.9%sodium chloride）. The parturients were evaluated by hospital anxiety and depression scale （HADS） and postpartum depression screening scale （PDSS）. Results The scores of HADS and PDSS 5 and 10 d after parturition in ketamine group were significantly lower than those in control group, HADS：（7.67 ± 2.53） scores vs. （10.48 ± 2.48） scores and （7.96 ± 2.61） scores vs. （11.24 ± 2.74） scores, PDSS：（52.58 ± 13.36） scores vs. （71.34 ± 15.19） scores and （53.73 ± 13.28） scores vs. （73.41 ± 15.37） scores, and there were statistical differences （P〈0.01）. The incidences of depression 5 and 10 d after parturition in ketamine group were significantly lower than those in control group：4.8%（3/63） vs. 15.9%（10/63） and 4.8%（3/63） vs. 17.5% （11/63）, and there were statistical differences （P〈0.05）. There were no serious adverse reactions in the 2 groups. Only 2 cases had mild nausea in control group, and the symptoms disappeared after adjustment. Conclusions The use of subanesthestic dose ketamine can significantly reduce the incidence of postoperative depression in cesarean section, and it has a good antidepressant effect.
作者
周劲松
阮剑辉
甘国胜
张蓉
李麟
吴明春
Zhou Jinsong, Ruan Jianhui, Can Guosheng, Zhang Rong, Li Lin, Wu Mingchun(Department of Anesthesiology, Wuhan General Hospital of PLA, Wuhan 430070, Chin)
出处
《中国医师进修杂志》
2017年第10期920-923,共4页
Chinese Journal of Postgraduates of Medicine
关键词
麻醉
氯胺酮
剖宫产术
抑郁
回顾性研究
Anesthesia
Ketamine
Cesarean section
Depression
Retrospective studies
