腹部严重多发性创伤患者术后并发应激障碍的影响因素研究

doi:10.3969/j.issn.1006-5253.2020.02.006

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摘要

目的分析腹部严重多发性创伤患者术后并发应激障碍的影响因素。方法对2016年1月至2019年2月在某院实施手术治疗的257例腹部严重多发性创伤患者进行回顾性研究，统计术后应激障碍发生率，探讨应激障碍发生的影响因素。结果 257例腹部严重多发性创伤患者术后并发应激障碍64例，发生率为24.9%。多因素分析发现，患者性别（OR=2.646）、受伤时恐惧情绪(OR=2.675)、ISS评分(OR=0.818)、性格(OR=1.536)、严重创伤既往史(OR=2.535)、SSRS评分(OR=0.616)、CDRISC评分(OR= 0.696)、VAS评分(OR=4.549)、HAD评分(OR=1.579)为腹部严重多发性创伤患者术后并发应激障碍的影响因素，差异有统计学意义（P＜0.05）。结论对女性、受伤时有恐惧情绪、内向性格、有严重创伤既往史、ISS评分＞35分、SSRS评分≤32分、CD-RISC评分≤45分、VAS评分＞5分、HAD评分＞12分的患者，需辅以心理支持、家庭社会支持及认知行为干预等相关干预，以减少术后应激障碍发生。

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	雷桂花
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	吴小青

关键词 ：腹部严重多发性创伤, 术后应激障碍, 影响因素

Abstract：Objective To analyze the influencing factors of postoperative stress disorder and the related nursing intervention strategies in patients with severe multiple trauma of the abdomen. Methods Totally 257 patients with severe abdominal trauma who underwent surgery in our hospital from January 2016 to February 2019 were enrolled in the study. The medical records were retrospectively analyzed and the incidence of postoperative stress disorder was statistically analyzed to explore the influencing factors of stress disorder. Results In 257 patients with severe multiple trauma to the abdomen, 64 patients had postoperative stress disorder with an incidence rate of 24.9%. Multivariate analysis found that the patients′ gender (OR=2.646), fear of injury (OR=2.675), and ISS score (OR=0.818), personality (OR=1.536), previous history of severe trauma (OR=2.535), SSRS score (OR=0.616), CD-RISC score (OR= 0.696), VAS score (OR=4.549), and HAD The score (OR=1.579) werethe influencing factors of postoperative complications of stress disorder in patients with severe multiple abdominal trauma, with significant statistical difference (P<0.05). Conclusion Patients with being female, with fear when hurt, introverted personality, history of severe trauma at the time of injury, ISS score>35, SSRS score≤32, CD-RISC score≤45, VAS score>5, or HAD score>12 need to be supplemented with psychological support, familysocial support and cognitive behavioral interventions to reduce postoperative stress disorder.

Key words： severe multiple trauma in the abdomen postoperative stress disorder influencing factor

收稿日期: 2020-10-01

通讯作者: 雷桂花，Email：lvvy727676676@163.com

引用本文:

雷桂花,叶丽珍,王燕,吴小青. 腹部严重多发性创伤患者术后并发应激障碍的影响因素研究[J]. 中国医院统计, 2020, 27(2): 115-118.
Lei Guihua, Ye Lizhen, Wang Yan, Wu Xiaoqing.. Study on the influencing factors of postoperative stress disorder in patients with severe multiple abdominal trauma. journal1, 2020, 27(2): 115-118.

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［1］张发理.急诊严重腹部创伤患者损伤控制外科手术治疗分析［J］.实用临床医药杂志,2017,21(21):212-213.

［2］张伟艳,李君颖,余红燕,等.多发伤患者创伤后应激障碍的高危因素及早期干预［J］.现代实用医学,2017,29(7):974-975.

［3］FERRETTI F,POZZA A, BOSSINI L, et al. A comparison of physical comorbidities in patients with posttraumatic stress disorder developed after a terrorist attack or other traumatic event［J］. J Neurosci Res, 2019, 97(5): 543-553.

［4］张赛,程世翔.创伤后应激障碍临床治疗的探索与思考［J］.中华创伤杂志,2018,34(11):988-990.

［5］李小冬,桂得春.损伤控制性外科技术在腹部严重创伤及急腹症救治中的应用价值［J］.新乡医学院学报,2017,34(8):748-750.

［6］杨鹤鸣,吴航滨,张长春,等.损害控制外科在严重腹部创伤休克救治的分阶段应用［J］.创伤外科杂志,2017,19(2):138-141.

［7］刘萍萍,张小雷,刘艳丰,等.焦虑、抑郁及脑部病灶特征对脑损伤患者急性应激障碍的影响［J］.中国老年学杂志,2019,39(11):2794-2797.

［8］董立焕,裴荷珠,唐启群,等.基于正念的音乐疗法对脑出血急性应激障碍伴睡眠障碍患者的影响［J］.护理学杂志,2019,34(8):15-18.

［9］SANTHANAM P, TESLOVICH T, WILSON SH, et al. Decreases in white matter integrity of ventrolimbic pathway linked to posttraumatic stress disorder in mild traumatic brain injury［J］. J Neurotraum, 2019, 36(7): 1093-1098.

［10］印怡臻,王安妮,张六一,等.遭受工作场所暴力的护士创伤后应激障碍影响因素研究［J］.护士进修杂志,2018,33(7):587-592.

［11］常丽鹏,袁太珍,龚国龄,等.影响创伤性骨折住院患者急性应激障碍的独立危险因素及干预措施［J］.安徽医学,2018,39(10):1185-1189.

［12］陈巧平,吴智鑫,朱艳桥,等.目击心肺复苏后发生创伤后应激障碍者的相关影响因素分析［J］.广东医学,2018,39(13):2050-2053.

［13］顾海英,陆根法,潘小芳,等.创伤后应激障碍患者生命质量与创伤后成长及津巴多时间观的相关性研究［J］.中国实用杂志, 2018,34(8):606-612.

［14］王玲,胡学军.重症监护室老年病人急性应激性精神障碍的研究进展［J］.实用老年医学,2018,32(11):1007-1008.

［15］KOCH S B, VAN ZUIDEN M, NAWIJN L, et al. Effects of intranasal oxytocin on distraction as emotion regulation strategy in patients with posttraumatic stress disorder［J］. Eur Neuropsychopharm, 2019, 29(2): 266-277.

［16］任宝玲,高惠玲,吕爱莉,等.三甲医院急诊护士述情障碍、社会阻抑对创伤后应激障碍的影响［J］.职业与健康,2018,34(19):2684-2688.

［17］王燕,吴小青,雷桂花.急诊危重患者创伤后并发应激障碍综合征的调查分析［J］.中国医院统计,2018,25(5):384-387.

［18］曹克勇,许碧华,冯玉勤,等.社会支持及应对方式对煤矿井下受伤工人创伤后应激障碍慢性化的影响［J］.现代医学卫生,2018, 34(15):2312-2314.

［19］张艳菊,赵润平,任俊华,等.急性应激障碍与创伤后应激障碍研究进展［J］.中华现代杂志,2018,24(12):1486-1488.

［20］刘东颖,封艳,沙晶,等.心理韧性对颅脑损伤患者创伤后应激障碍影响的研究［J］.管理杂志,2018,18(12):847-850.

［21］霍红秋,侯婧悦,蒋晓忠,等.唐山震后创伤后应激障碍对肝硬化患者自我健康管理水平的影响［J］.中国临床研究,2019,32(1):107-110.