摘要
目的:探讨严重创伤患者并发创伤后应激障碍相关因素及防治对策.方法:回顾性分析2021年4月—2023年4月河南科技大学第一附属医院收治的95例严重创伤患者临床资料.采用创伤后应激障碍自评量表(PTSD-SS)评价创伤后应激障碍水平,根据评分将其分为两组.收集患者一般资料及慢性健康状况评分系统(APACHFⅡ)评分、社会支持、就医时间(≥4h、＜4h)等.对一般资料进行单因素分析,再对差异有统计学意义的变量进行logistic回归分析.结果:95例患者中,有38例患者发生创伤后应激障碍,发生率为40％;单因素分析结果显示,两组患者家庭月收入水平、创伤类型、是否有脓毒症、是否遗留残疾、心理弹性、APACHF Ⅱ评分、社会支持比较,差异有统计学意义(x2=18.581、12.789、5.247、11.053、18.581、8.118、8.143,P＜0.05);logistic 回归分析结果显示,家庭月收入水平＜5 000元、开放性创伤、有脓毒症、遗留残疾、心理弹性欠佳、APACHF Ⅱ评分≥20分、社会支持欠佳是影响严重创伤患者并发创伤后应激障碍的独立危险因素(OR=7.207、4.800、5.398、5.195、7.207、3.459、3.897).结论:家庭月收入水平＜5 000元、开放性创伤、有脓毒症、遗留残疾、心理弹性欠佳、APACHF Ⅱ评分≥20分、社会支持欠佳是导致严重创伤患者出现创伤后应激障碍的主要原因,临床应加以重视,制定针对性防治对策.
Abstract
Objective:To explore the related factors and prevention and treatment strategies of severe trauma patients complicated with post-traumatic stress disorder.Methods:A retrospective analysis was conducted on the clinical data of 95 patients with severe trauma admitted to the hospital from April 2021 to April 2023.The level of post-traumatic stress disorder was evaluated with PTSD-SS scale,and they were divided into two groups based on their scores.General information about patients,chronic health status scoring system(APACHF Ⅱ)scores,social support,and medical treatment time(≥4 hours,＜4 hours)were collected.Single factor analysis on general data,and multivariate logistic regression analysis on those with statistical differences were conducted.Results:A total of 38 cases of post-traumatic stress disorder occurred in 95 patients,with an incidence rate of 40.00％.Univariate analysis showed that there was statistically significant difference between the two groups in terms of monthly income level,trauma type,presence of sepsis,residual disability,psychological resilience,APACHF Ⅱscore,and social support(x2=18.581,12.789,5.247,11.053,18.581,8.118,8.143;P＜0.05).Logistic regression analysis showed that family monthly income level＜5000 yuan,open trauma,sepsis,residual disability,poor psychological resilience,APACHF Ⅱ score≥20 points,and poor social support were independent risk factors for severe trauma patients complicated with post-traumatic stress disorder(OR=7.207,4.800,5.398,5.195,7.207,3.459,3.897).Conclusion:Family monthly income levels＜5 000 yuan,open trauma,sepsis,residual disability,poor psychological resilience,APACHF Ⅱ score≥20 points,and poor social support are the main causes of post-traumatic stress disorder in severe trauma patients.Clinical attention should be paid to it,and targeted prevention and treatment strategies should be developed.
维普
万方数据