摘要
目的:探讨重度烧伤患者伤后应激障碍的发生情况。方法:以2010年4月至2011年6月间浙江大学医学院附属第二医院烧伤科收治的27例重度烧伤患者为研究对象，创面治疗和心理疏导同步。分别于伤后1个月和伤后1年，对患者进行症状自评量表（SCL-90）、艾森克人格测验（EPQ）、事件影响量表-修订版（IES-R）测评，判定患者是否存在创伤后应激障碍（PTSD）。结果:27例重度烧伤患者均被诊断为急性应激障碍，所有患者伤后1个月SCL-90的躯体化评分高于国内常模[（1.66 ± 0.46）分vs.（1.37 ± 0.48）分，t = 3.112，P = 0.002]，人际关系敏感评分低于国内常模[（1.35 ± 0.26）分vs.（1.65 ± 0.61）分，t = 2.550，P = 0.011]，其他因子与国内常模比较差异均无统计学意义（P均> 0.05）。完成1年随访的10例患者中，与伤后1个月比较，各因子间评分差异均无统计学意义（P均> 0.05）；且IES-R测评显示，没有患者达到PTSD阳性筛查标准，其中2例为亚临床创伤后应激反应症状，7例为轻度创伤后应激反应症状，1例为中度创伤后应激反应症状。结论:重度烧伤患者存在急性应激障碍和创伤后应激反应症状，早期进行心理疏导和药物干预值得探索。
Abstract
Objective:To study the occurrence of post-traumatic stress disorder (PTSD) in patients with severe burns.Methods:A total of 27 patients with severe burns admitted to the Department of Burns in the Second Affiliated Hospital Zhejiang University School of Medicine from April 2010 to June 2011 were selected as the research objects. Wound treatment and psychological counseling were carried out simultaneously. Symptom checklist-90 (SCL-90), Eysenck personality questionnaire (EPQ) and impact of event scale-revised (IES-R) were used to evaluate patients with PTSD on one month and one year after injury.Results:A total of 27 severe burn patients were diagnosed with acute stress disorder. In the SCL-90, the somatization score of 27 severe burn patients on one month after injury was higher than that of the national norm [(1.66 ± 0.46) vs. (1.37 ± 0.48), t = 3.112, P = 0.002], the interpersonal sensitivity score was lower [(1.35 ± 0.26) vs. (1.65 ± 0.61), t = 2.550, P = 0.011], and there were no significant differences between other factors and the domestic norms (all P > 0.05). In the 10 patients who completed one-year follow-up, there were no significant differences in scores among all factors compared with one month after injury (all P > 0.05). In addition, the IES-R indicated that no patient met the positive screening criteria for PTSD, including two patients of subclinical post-traumatic stress symptoms, seven patients of mild post-traumatic stress symptoms and one patient of moderate post-traumatic stress symptoms.Conclusion:Severe burn patients have acute stress disorder and post-traumatic stress symptoms, and early psychological counseling and drug intervention are worth exploring.
基金项目
浙江省基础公益研究计划项目(LGF20H150004)
浙江省医药卫生科技计划项目(N2009A105)
万方数据