【摘要】 目的探讨产后抑郁症患者与产科相关的高危因素,以及评价心理干预的效果。方法采用分层整群抽样的方法,随机抽取产后42d内复查的210例初产妇,进行问卷调查。调查问卷包括:爱丁堡产后抑郁量表(EPDS)、自编产科情况调查问卷。对抑郁组患者采用心理干预的方法,结合产妇的社会心理特点,采取相应的心理干预和心理治疗,在产后3个月时再次评定爱丁堡产后抑郁量表,评价心理干预的效果。结果 210例初产妇确诊抑郁症36例,发病率为17.14%。多因素非条件回归分析显示:孕妇学校培训、第一产程时间、顺产、阴道助产、新生儿畸形、母乳喂养、新生儿出生阿氏评分与产后抑郁症相关,差异有统计学意义(P<0.05)。通过对抑郁症组患者随机分成两组,认知行为治疗组与未进行治疗组相比较,差异具有统计学意义。结论顺德区产后抑郁症的发病率为17.14%,相关的产科抑郁因素有阴道助产,新生儿畸形,第一产程延长,新生儿出生阿氏评分;保护因素有参加孕妇学校培训,顺产,母乳喂养。针对影响因素,所采取相应的干预措施,可明显有助于改善产后抑郁症。更多还原

【Abstract】 Objective To explore the obstetrical-related risk factors in post-natal depression patients,and evaluate the effect of psychological intervention.Methods Stratified cluster sampling method was used,210 primigravida in 42 days after birth were randomly extracted for questionnaire.The questionnaire included: Edinburgh Postnatal Depression Scale(EPDS),obstetrical information questionnaire.Appropriate psychological intervention and psychological treatment in depression groups were adopted by considering patients’ social and psychological characteristics.3 months after birth,the EPDS again to observe the effect of psychological intervention were evaluated.Results 36 cases were made a definite diagnosis of depression,morbidity is 17.14%.Binary logistic regression showed that: pregnant school,first labor time,natural labor,vaginal birth,newborns malformations,breastfeeding,apgar score of birth were all related with post-natal depression,which had statistical significance(P<0.05).Apart all the depression patients into two groups: treatment group and cognitive behavior therapy group.Significant difference through comparison between the two groups was found.Conclusion The post-natal depression morbidity in Shunde city was 17.14%.The related depressed factors included: vaginal birth,newborns malformations,first labor time,postpartum hemorrhage,apgar score of birth.The protective factors included: pregnant school,natural labor,breastfeeding.According to influence factors,corresponding preventive measures can obviously help to improve the post-natal depression.更多还原