中国医学创新2025，Vol.22Issue(15)：137-141,5.DOI:10.3969/j.issn.1674-4985.2025.15.031
艾司氯胺酮在防治剖宫产产后抑郁中的临床研究
Clinical Study of Esketamine in Prevention and Treatment of Postpartum Depression after Cesarean Section
摘要
Abstract
Objective:To explore the application value of Esketamine in the prevention and treatment of postpartum depression after cesarean section.Method:A total of 80 parturients who underwent cesarean section and were admitted to Pingxiang People's Hospital and Luxi County People's Hospital from July 2022 to February 2023 were selected and divided into the study group and the control group according to the random number table method,with 40 cases in each group.Both groups were intravenously injected with 5 mL of the analgesic pump solution after the delivery of the fetus,and the patient-controlled intravenous analgesic pump was connected after the operation.The control group was given 15 μg/kg Remifentanil+100 μg/kg Butorphanol+2.5 mg of Flupperidone,while the study group was added with 1 mg/kg Esketamine on the basis of the control group.The perioperative indicators,pain score[visual analogue scale(VAS)],depression score[Edinburgh postnatal depression scale(EPDS)],stress indicators[cortisol(Cor),norepinephrine(NE),adrenocorticotropic hormone(ACTH),thyroid stimulating hormone(TSH),hypersensitive C reactive protein(hs-CRP)]and the incidence of adverse reactions between the two groups were compared.Result:The time of getting out of bed for activities,the time of flatulence,the time of first breastfeeding and the length of hospital stay in the study group were all shorter than those in the control group,and the number of additional drug administration was less than that in the control group(P<0.05).At 4,8,24 and 48 h after the operation,the VAS scores of the study group were all lower than those of the control group(P<0.05).At 1 week and 6 weeks postpartum,the EPDS scores of the study group were lower than those of the control group(P<0.05).One day after delivery,the levels of serum Cor,NE and ACTH in the study group were all lower than those in the control group(P<0.05).Three days after delivery,the serum TSH level in the study group was higher than that in the control group,and the hs-CRP level was lower than that in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Esketamine has a significant effect in postpartum depression after cesarean section and can safely and effectively prevent the occurrence of postpartum depression.关键词
艾司氯胺酮/剖宫产/产后抑郁/应激/疼痛/促甲状腺素/超敏C反应蛋白Key words
Esketamine/Caesarean section/Postpartum depression/Stress/Pain/Thyrotropin/Highly sensitive C reactive protein引用本文复制引用
周兵,彭洪,王圣文,叶麒..艾司氯胺酮在防治剖宫产产后抑郁中的临床研究[J].中国医学创新,2025,22(15):137-141,5.基金项目
江西省卫生健康委科技计划项目(202212173) （202212173）
