杨薇

[摘要]目的 觀察家庭陪伴围生期护理在合并抑郁倾向产妇中的应用效果。方法 选取2017年1月～2018年12月我院收治的106例产妇作为研究对象，按照入院时间将2017年收治的53例产妇纳入常规组，2018年收治的53例产妇纳入家庭组。常规组采用常规围生期护理，家庭组采用家庭陪伴围生期护理，比较两组母婴结局、分娩并发症发生情况，分娩后5 d评估两组的精神状态，随访1个月评估两组产后抑郁症、精神病性症状发生率。结果 家庭组自然分娩率为83.02%、新生儿异常率为5.66%、难产率为15.09%、总产程时间为（5.23±1.21）h，常规组依次为64.15%、22.64%、32.08%、（8.46±1.35）h，家庭组自然分娩率高于常规组，新生儿异常率、难产率低于常规组，家庭组总产程时间短于常规组，差异均有统计学意义（P<0.05）。家庭组产后无泌乳、便秘、创口感染发生率低于常规组，差异均有统计学意义（P<0.05）;分娩后5 d，家庭组汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、阴性与阳性症状量表（PANSS）评分低于常规组，差异均有统计学意义（P<0.05）。随访1个月，家庭组产后抑郁症（PPD）发生率为9.43%、伴精神病性症状发生为1.89%，低于常规组的24.53%、13.21%，差异均有统计学意义（P<0.05）。结论 家庭陪伴围生期护理可有效改善合并抑郁倾向产妇的精神状态，降低母婴不良结局发生风险，能在一定程度上预防产妇发生产后抑郁症。

[关键词]围生期护理;产后抑郁症;家庭陪护;母婴结局

[中图分类号] R473.71          [文献标识码] A          [文章编号] 1674-4721（2020）5（a）-0239-04

Application effect of family companion perinatal nursing in women with depression tendency

YANG Wei

Department of Gynecology and Obstetrics， the Second People′s Hospital of Jingzhou City， Hubei Province， Jingzhou   434000， China

[Abstract] Objective To observe the effect of family companion perinatal nursing in women with depression. Methods A total of 106 women with depressive propensity who were admitted to our hospital from January 2017 to December 2018 were selected. According to the admission time， 53 women who were admitted in 2017 were included in the routine group， and 53 women who were admitted in 2018 were included in the family group. The routine group used routine perinatal nursing， and the family group used family companion perinatal nursing. The maternal and child outcomes and the complications of childbirth were compared between the two groups. The mental state of the two groups was evaluated 5 days after delivery. The follow-up period was 1 month. The incidence of postpartum depression and psychotic symptoms in the two groups was evaluated. Results The natural delivery rate of the family group was 83.02%， the neonatal abnormal rate was 5.66%， the difficult labor rate was 15.09%， the total labor time was （5.23±1.21） h， and the routine group was 64.15%， 22.64%， 32.08%， （8.46±1.35） h， the natural delivery rate of the family group was higher than that of the routine group， the abnormal rate of the newborn， and the dystocia were lower than those of the routine group. The total maternal duration of the family group was shorter than that of the routine group， and the differences were statistically significant （P<0.05）. The incidence of lactation， constipation and wound infection were lower than the routine group， the differences were statistically significant （P<0.05）. On the 5th days after delivery， the family group maternal Hamilton anxiety scale （HAMA）， Hamilton depression scale （HAMD）， negative and the positive symptom scale （PANSS） scores were lower than the routine group， the differences were statistically significant （P<0.05）. The follow-up period of 1 month， the incidence of postpartum depression （PPD） in the family group was 9.43%， accompanied by psychotic symptoms for 1.89%， were lower than that of the routine group for 24.53% and 13.21%， respectively， the differences were statistically significant （P<0.05）. Conclusion Family companion perinatal nursing can effectively improve the mental state of women with depression tendency， reduce the risk of maternal and child adverse outcomes， and prevent maternal postpartum depression to  certain extent.

[Key words] Perinatal nursing; Postpartum depression; Family escort; Maternal and child outcomes

产后抑郁症（postpartum depression，PPD）为产妇产后发生的精神系统并发症[1-2]。多由产后出现生理、心理及社会角色转变等因素所诱发的抑郁症状，主要可见焦虑、少言、易激怒、易哭泣、应对能力减低等表现，部分严重产妇可伴有妄想、幻觉等精神病性症状，甚至出现自杀、杀婴等情况。PPD多为产后4周发生抑郁症，但产后12个月均可能发生PPD[3-4]。通常围生期即可见PPD初期倾向，产后4～6周时症状逐渐显著，病程甚至可持续1～2年[5]。目前我国实行“二孩”政策，临床产妇情况更复杂，PPD的发生率亦出现明显升高[6]。围生期PPD倾向可导致PPD发生风险升高，给分娩及母婴结局造成不良影响。PPD的发生不仅给产妇造成极大痛苦，还可能直接干扰婴儿的生长发育，甚至使婴儿出现认知功能、语言能力发育迟滞，发生行为异常、不安全与疏离依恋关系等情况。……