摘要
目的:探究老年车祸多发伤患者创伤后应激障碍(PTSD)的影响因素及相关对策.方法:回顾性分析2016年7月—2021年7月于浙江大学医学院附属杭州市第一人医院接受治疗的100例老年车祸多发伤患者临床资料,根据患者是否发生PTSD分组,将发生PTSD的患者设为观察组(n=42),将发生未PTSD的患者设为对照组(n=58).比较两组患者一般资料、病情等差异,将存在差异的单因素纳入Logistics回归分析,分析影响PTSD发生的危险因素.结果:单因素分析结果显示,性别、年龄、车祸死亡人数、是否遗留残疾是影响PTSD发生的单因素(均P<0.05);将影响PTSD发生的单因素代入多因素Logistic回归分析方程中发现,女性(95%CI:1.051～4.195,OR=2.100,P<0.05)、年龄≥80 岁(95%CI:1.103～3.372,OR=1.929,P<0.05)、车祸死亡人数≥2(95%CI:1.090～2.654,OR=1.701,P<0.05)、遗留残疾(95%CI:1.150～2.877,OR=1.818,P<0.05)是影响PTSD发生的独立危险因素.结论:老年车祸多发伤患者发生PTSD的独立危险因素包括性别、年龄、车祸死亡人数及遗留残疾,临床应根据患者病情提高患者PTSD知晓情况,并予以心理治疗.
Abstract
Objective:To explore the influencing factors and related countermeasures of post-traumatic stress disorder(PTSD)in elderly patients with multiple injuries in car accidents.Methods:The clini-cal data of 100 elderly patients with multiple injuries in car accidents who were treated in the Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine were retrospectively ana-lyzed between July 2016 and July 2021.According to whether PTSD occurred in patients or not,they were divided into the observation group(with PTSD,n=42)and the control group(without PTSD,n =58).The general data and disease condition were compared between the two groups,and the signifi-cant factors after univariate analysis were included in the logistic regression for PTSD risk factors analysis.Results:Univariate analysis showed that gender,age,the number of fatalities in the acci-dent,and residual disabilities were the single factors affecting the occurrence of PTSD(all P<0.05).By multivariate logistic regression analysis,it was found that female(95%CI:1.051-4.195,OR= 2.100,P<0.05),age≥80 years old(95%CI:1.103-3.372,OR=1.929,P<0.05),the number of deaths in car accidents≥2(95%CI:1.090-2.654,OR=1.701,P<0.05),and remaining disability(95%CI:1.150-2.877,OR=1.818,P<0.05)were independent risk factors for the occurrence of PTSD.Conclusion:The independent risk factors of PTSD in elderly patients with multiple injuries in car accidents include gender,age,the number of fatalities in the accident,and residual disabilities.Clinically,it is necessary to improve PTSD awareness and perform psychological therapy on patients according to the disease condition of patients.
基金项目
浙江省医药卫生科技项目(2020KY687)
杭州市医学重点学科建设基金资助项目(杭卫发[2021]21号)
NETL
NSTL
万方数据