珠江三角洲创伤事故后应激障碍的发生及影响因素分析

The Prevalence and Risk Factors of Posttraumatic Stress Disorders after Accidents in the Pearl River Delta Region

目的了解珠江三角洲地区创伤事故后住院患者应激障碍(PTSD)症状的发生情况并分析影响因素。方法于2009年4月-2010年2月抽取珠江三角洲地区6个城市7所医院住院创伤患者,采用自编问卷和创伤后应激障碍症状自评量表(PCL-C量表),调查PTSD症状发生率并分析影响因素。结果①554例有效样本PCL-C评分均值为(31.94±11.68),PTSD症状筛查阳性率为28.5%(PCL-C分值≥38分),其中重度为7.8%(分值≥50分);②影响因素分析显示,女性(χ2=15.937,P<0.001)、受教育程度低(χ2=9.597,P<0.05)、多部位伤(χ2=8.093,P<0.01)、预期生活自理程度差(χ2=15.757,P<0.001)、预期无工作能力(χ2=19.036,P<0.001)的患者PTSD症状发生率较高;③社会支持方面,缺乏友情精神支持的患者PTSD的发生率较有大量友情支持的患者高(χ2=13.307,P<0.05)。结论珠江三角洲地区创伤事故后PTSD症状发生率较高,性别、受教育程度、创伤严重程度、对未来生活的不良预期及缺乏社会友情支持是主要的影响因素。

Objective To investigate the prevalence and related risk factors of Post Traumatic Stress Disorders（PTSD）after accidents in the Pearl River Delta region.Methods Inpatients after accidents from April 2009 to February 2010 in seven hospitals of the Pearl River Delta cities were surveyed with self-made questionnaire and PTSD Checklist-Civilian Version（PCL-C）.Results ①Totally 554 cases were valid,the PCL-C mean value was（31.94±11.68）,A prevalence of 28.5% for PTSD symptoms were found in this region with 7.8%（marks≥50）for severe degree.②Risk factors analysis showed that female（χ2=15.937,P0.001）,lower education degree（χ2=9.597,P0.05）,multiple injury（χ2=8.093,P0.01）,proleptic disability of self-care（χ2=15.757,P0.001）,incapable of working（χ2=19.036,P0.001）were associated with greater odds of PTSD.③ Patients who lacked help from friends were associated with greater odds of PTSD than those who had many friends to help.Conclusion The prevalence of PTSD symptoms is relatively high in patients after accidents in the Pearl River Delta.Sex,education degree,injury severity,anticipation for future life and social support are main risk factors.