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目的探讨剖宫产孕妇术前心理状况对母婴结局的影响,为临床诊疗提供依据。方法选取2015年1月-2016年1月新疆医科大学第一附属医院收治的剖宫产孕妇2 030例,术前应用汉密顿焦虑量表(HAS)评价孕妇心理状况,根据是否焦虑将孕妇分为焦虑组(257例)和正常组(1 773例),采用Logistic多因素分析剖宫产孕妇术前焦虑的危险因素,并比较两组母婴结局。结果 2 030例剖宫产孕妇中,257例术前出现焦虑状态,占12.66%;1 773例术前未出现焦虑状态,占87.34%。单因素分析发现:家庭月均收入、居住条件、婆媳关系、流产次数、朋友分娩情况、孕期听课情况均与剖宫产孕妇术前焦虑有关(P<0.05)。Logistic多因素分析显示:家庭月均收入、居住条件、婆媳关系、流产次数、朋友分娩情况、孕期听课情况是影响剖宫产孕妇术前焦虑的危险因素。焦虑组术中出血量显著多于正常组,Apgar评分显著低于正常组,差异均有统计学意义(P<0.05)。结论剖宫产孕妇术前存在焦虑,焦虑会增加术中出血量,降低婴儿Apgar评分。
Objective To investigate the effect of preoperative psychological status of maternal cesarean section on maternal and infant outcomes and provide evidence for clinical diagnosis and treatment. Methods 2 030 pregnant women undergoing cesarean section were selected from the First Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2016. The psychological status of pregnant women was evaluated by HAM before surgery and the pregnant women Divided into anxiety group (257 cases) and normal group (1773 cases). Logistic multivariate analysis of risk factors for preoperative anxiety in cesarean section pregnant women, and compared the two groups of maternal and infant outcomes. Results Among 2 030 pregnant women with cesarean section, 257 had anxiety state preoperatively, accounting for 12.66%; 1 773 had no preoperative anxiety state, accounting for 87.34%. Univariate analysis showed that the average monthly family income, living conditions, the relationship between mother and daughter, the number of miscarriage, the delivery of friends and pregnancy were all related to the preoperative anxiety of pregnant women with cesarean section (P <0.05). Logistic multivariate analysis showed that the average monthly family income, living conditions, the relationship between mother-and daughter-in-law, the number of abortions, the status of friends and childbirth, and the attendance during pregnancy were the risk factors of preoperative anxiety in pregnant women with cesarean section. The amount of bleeding in the anxiety group was significantly higher than that in the normal group, and the Apgar score was significantly lower than that in the normal group (P <0.05). Conclusion Anxious anxiety exists in preoperative cesarean section pregnant women. Anxiety can increase intraoperative blood loss and decrease Apgar score in infants.