产后抑郁 (2)

null产后抑郁症 Postpartum depression产后抑郁症 Postpartum depressionnull小组成员nullPostpartum depression also called postpartum depression, are women in production children due to physiological and psychological factors after the depression, thoughts and actions.产后抑郁症也称为产后抑郁症,是妇女在生产儿童由于生理和心理因素在低落之后引起的思想和行动。null产后抑郁症的高危妇女 What kind of people are predisposed to postpartum depression ? 1 完美主义性格 Perfect principle disposition 因为产后女性对产后的保健期望高没但有现实的,而且在遇到困难时不想寻求帮助,因此她们将可能出现不适应母亲的角色。 Because post-natal health care the perfect principle's female to post-natal works as down to mother's expectation high has not been realistic, moreover in meets the difficult time does not want the seek help, therefore they will possibly be unable suitably to a new mother. 女性缺乏丈夫在精神上的支持,他们会认为将有巨大的压力。 Moreover if the husband are very few together the see after children or the female lacks husband support spiritually, they will think that will have the huge pressure. null2怀孕期间有情绪波动 Being pregnant period has had mood fluctuation 怀孕期间有严重的情绪波动,有亲戚和朋友离开，重大变故和战争等等，会使孕妇更容易有产后抑郁症的发生。许多都显示,多数女性怀孕已经证明产生抑郁的迹象,包括很多产妇将继续在产后情绪更加沮丧抑郁。 Being pregnant period has had the serious mood fluctuation, like moves, has the relatives and friends to leave passes, or the war and so on will make the pregnant woman to be easier to have the post-natal depression. Many cases demonstrated that the majority of females are after the being pregnant time already demonstrated produces depression indication, including many will continue in the post-natal despondent mood to deepen. null产后抑郁症的心理因素 Psychological factors of postpartum depression没有做好为人母的准备 Has not completed prepare to be mother 心理不成熟 Mental also immature 脾气不好 Like having a fit of temper, loving the fresh sulks 夫妻感情不好 The husbands and wives sentiment is not too good 婆媳矛盾 Mothers and daughters-in-law relations disagreement 对孩子的性别歧视 Has the sexual discrimination to the child 对于日常必需品问担心 For daily necessities question worry 在分娩的时候不能有一个良好的睡眠 In the time of childbirth cannot have a good sleep null产后抑郁的临床现以心境低落为主，并至少有下列四项： 　　①　兴趣丧失、无愉快感； 　　②　精力减退或疲乏感； 　　③　精神运动性迟滞或激越； 　　④　自我评价过低、自责、或有内疚感； 　　⑤　联想困难或自觉思考能力下降； 　　⑥　反复出现想死的念头或自杀、自伤行为； 　　⑦　睡眠障碍，如失眠、早醒，或睡眠过多； 　　⑧　食欲减低或体重明显减轻； 　　⑨　性欲减退。 Emotional change The most prominent is the persistent depression, manifested as gloomy performance, lethargy, drowsiness, and crying tears easily Cognitive change Lack of patience interests in daily activities , often feel inferior, blame themselves, feel guilty , and some behavioral changes behavior change Patients will decrease their activity, they are very difficult to concentrate on work, even though they may have ideals and aspirations, but rarely do serious. Body symptom insomnia, headaches, body pain, dizziness, vertigo, tinnitus null产后抑郁症的临床表现与一般抑郁症相同，其显著特征是产妇情绪低落，呈心理功能下降或社会功能受损的消极情绪状态，持续时间较长。其主要表现为： ①常感到心情压抑、沮丧、情感淡漠； ②自我评价较低，自暴自弃、自责、自罪，或对身边的人充满敌意、戒心，与家人关系不协调； ③创造性思维受损； ④对生活时常缺乏信心，觉得生活无意义，表现为厌食、睡眠障碍、易疲倦；重者甚至绝望，出现自杀或杀婴倾向，有时陷于错乱或昏睡状态。 symptoms caused by a nervous, doubt, guilt, fear, a few serious will have despair, runaways, hurt the child or suicidal 产后抑郁预防 产后抑郁预防 Postpartum women's emotional change will be very big. Some maternal postpartum feelings become very fragile, frequently cry, sad, angry, injustice, but also special fatigue, loss of appetite, decreased sexual drive, insomnia, and at the same time, work efficiency and ability to reduce, also cannot very good care of children, to do the mother's responsibility.产后女性的情绪变化会非常大。有些产妇在产后感情变得很脆弱，动辄哭泣、伤心、委屈、发脾气，还特别容易疲劳、食欲不振、性欲减低、失眠，同时，做事的效率及能力减低，也不能很好地照顾孩子，履行做母亲的职责等。 null分娩对于产妇是一种很强的刺激，同时常常伴随着不安的情绪。分娩以后体内孕激素和雌激素水平的急剧下降，引起人的情绪不稳是造成产后抑郁的主要基础。此外，难产、产褥感染、产后出血过多、分娩时疲劳、照料婴儿等负担，加上家务琐事的不顺心，婆媳、夫妻关系不协调等，都与产后抑郁的发生有关。显然，预防产后抑郁，不只是产妇一个人的问题，而是整个家庭的问题。 Delivery for maternity is a kind of very strong stimulation, and at the same time, often accompanied by anxiety. After childbirth body progestational hormone and estrogen level fell sharply, causing the person's mood instability is caused by the main basis of postpartum depression. In addition, dystocia, puerperal infection, postpartum hemorrhage too much, during fatigue, to look after the baby and other burdens, coupled with household chores is not satisfactory, old woman daughter-in-law, husband and wife relationship not harmonious, etc., and the occurrence of postpartum depression related. Obviously, to prevent postpartum depression, not only the puerpera a person's question, but the whole family problems.null首先，产妇在怀孕期间应阅读一些有关孕产妇心理、生理及小儿护理方面的知识，以充实自己，从思想上做好准备，培养和锻炼自己把握心理平衡的能力； First of all, maternity in pregnancy should be read something about the maternal psychological, physiological and child care knowledge, in order to enrich himself, from the thought ready, develop and strengthen their ability to grasp the psychological balancenull第二，医务人员和家属要正确认识分娩后产妇心理行为的改变，理解产妇分娩后情绪的改变是由于内分泌的突然改变造成的，因而，家人特别是丈夫要倍加关心、体贴产妇，给予更多的帮助； Second, the medical staff and families to the correct understanding after childbirth puerpera psychological behavior change, understand maternity after the change of mood is due to the sudden change of endocrine cause, therefore, family especially husband to was caring, being considerate maternity, give more help null第四，一旦发现产妇有心理、行为的异常，应尽快找心理医生治疗。 Fourth, once found maternal psychological and behavior abnormalities, should look for psychological doctor treatment as soon as possible. 第三，对于有孕产期合并症、并发症者，更应给予帮助，避免产后过度疲劳 Third, for there complication, complications, person, should give more help, avoid postpartum excessive fatigue 产后抑郁护理要点产后抑郁护理要点在分娩前要了解产妇的精神状态 Before delivery to understand maternity state of mind 对于产后抑郁护理这一问题，也要注意介绍相关的分娩知识和分娩过程，使产妇认识到分娩是一种正常的生理过程，对所要经历的痛苦有足够的心理准备，帮助产妇以积极心态迎接即将到来的分娩，消除紧张、恐惧的消极情绪，避免产生产后抑郁。 For postpartum depression nursing this problem, also want to pay attention to introduce related childbirth knowledge and the process of delivery, make the puerpera realize delivery is a normal physiological process, to have to experience pain have enough psychological preparation, help mothers with a positive mental attitude to meet the upcoming birth, eliminate tension, fear of negative emotions, avoid to produce postpartum depression.null分娩过程中护理人员尽量在旁陪伴和指导 In the process of childbirth nursing staff as far as possible in the company and guide 给予安慰和鼓励，教会其如何在阵痛间歇中运用放松的技巧，消除其无助感，增强分娩的信心。 Give comfort and encouragement, the church how it in pain intermittent use relaxed skills, eliminate the helplessness, enhance the confidence of the delivery. 允许家属陪伴，给予关怀和照顾，减轻孤独感，缓解紧张心理。及时补充易消化的食物和水分，减少产程中体力和精力的消耗。对剖宫产的产妇要做好术前心理护理产后抑郁的问题，减轻对手术的恐惧和担忧。 Allow family company, give concern and care, reduce loneliness, alleviate nervous psychology. Timely supplement digestible food and water, reduce the labor strength and energy consumption. For cesarean section of the parturient women must complete preoperative psychological nursing postpartum depression problem, reduce the operation of fear and worry. null产后给予一个安静舒适的环境适当限制亲友的探视，护理工作尽量集中，提高效率，使产妇有充足的休息。给予易消化富含营养的食物，使产妇尽快恢复体力，大大降低产后抑郁出现的可能性这也是产后抑郁护理的方法之一。对分娩经受了异常痛苦或有不良妊娠结局的产妇给予重点心理护理，注意保护性医疗，避免精神刺激导致产后抑郁。 临床案例：临床案例：陈某，女，28岁，大学毕业后，在一家著名外资企业任职。因其天姿秀丽，性格开郎、活泼，深得男士们的钟爱，不乏追求者。两年前，她与相互倾心多年的男友喜结良缘。婚后俩人恩爱有加，小日子过得甜甜蜜蜜，一年后，小陈的腹部日渐膨胀，爱情种子在俩人精心孕育下悄悄发芽。一月前终成正果，小家伙在全家人的期盼和祝福下顺利降生。是个男孩，7斤8两重，一头黑发，面色红润，一双大大的眼睛，是个人见人爱的小天使。在亲人们的精心呵护下，母子平安，小家伙健康成长。可是在孩子满月后，家人发现小孩的母亲小陈发生一些变化。她白天总是无精打彩，缺少笑容，晚上又睡不着觉。怕声响和光亮，心情压抑、烦躁、易发脾气，对什么都没兴趣，不思茶饭，奶水明显减少。总担心孩子会生病，怀疑自己能否把孩子养大，甚至有抱孩子去跳楼，一齐死去的可怕念头，为了怕害死小孩，常常强迫自己不去靠近，不去抱小孩。望着小陈日益消瘦的面庞。家人都很着急，怎么去开导、劝解和鼓励，都没有什么作用。经家人送她到我院心理科门诊拟“产后抑郁症”收住院，通过积极的认知心理治疗和百优解抗抑郁药物的治疗。两周后小陈的情况明显好转，脸上又见到了笑容。往日自信、开朗、健康的小陈复活了。 null爱丁堡产后抑郁量表（EPDS） 　　是国内外运用较多的产后抑郁筛查量表之一，为自评量表，共有10个项目，分别涉及心境、乐趣、自责、焦虑、恐惧、失眠、应付能力、悲伤、哭泣和自伤等，根据症状严重程度分为4级评分，得分范围0～30分，9分为筛查产后抑郁的临界值，12分作为筛查重性产后抑郁的临界值。附表：爱丁堡产后抑郁量表（EPDS） 　　 null