珠江三角洲创伤事故后患者应激障碍症状的调查分析

Investigation of posttraumatic stress disorders after accidents in Pearl River Delta

目的探讨珠江三角洲地区创伤事故后患者应激障碍(PTSD)症状的发生情况并分析危险因素。方法于2009年4月至2010年2月抽取珠江三角洲地区的广州、深圳、珠海等6市7所医院住院创伤患者554例,采用PTSD平民版筛查问卷(PCL-C)及自编影响因素调查表,调查PTSD症状发生率,分析症状特点及影响因素。结果 158例患者PCL-C分值大于或等于38分,PTSD症状筛查阳性率28.5%,其中重度为7.8%(分值大于或等于50分),轻、中度20.8%(分值38～49分),创伤事故后患者最主要的偏重和严重症状是:"面临相类似的情景时会非常局促不安(44.3%)"、"入睡困难或易醒(36.7%)"、"创伤经历引起的反复发生令人不安的记忆、想法或形象(31.1%)"等。多因素分析显示,女性、生活不能自理、丧失工作能力、缺乏友情支持、多部位伤及距事故发生时间较长与PTSD症状发生有关。结论珠江三角洲创伤事故后PTSD症状发生率较高,反复重现体验增多,需要早期识别和干预。

Objective To investigate the incidence and related risk factors of post-traumatic stress disorders （PTSD） after acci- dents in the Pearl River Delta. Methods Inpatients after accidents from April 2009 to February 2010 in seven hospitals of the Pearl River Delta cities, such as Guangzhou, Shenzhen and Zhuhai, were surveyed with PTSD Checklist-Civilian Version （PCL-C） and self-made questionnaire. Results In a total of 554 post traumatic patients,a prevalence of 28.5% of PTSD symptoms were found in this region with 7.8% （marks≥50） of severe degree and 20.8% （marks：38-49） of mild to moderate degree. In the severe PTSD symptoms group, the top three items were getting nervous and upset once faced similar situation,difficulty sleeping or easy to be a- wake, and the trauma experience caused recurring disturbing memory, ideas or image. Multivariate analysis showed that female, una- ble self-care,incapable of working,lack help from friends, multiple injury, and injury time longer were all associated with the PTSD symptom incidence. Conclusion The prevalence of PTSD symptoms is relatively high in injured patients after accidents in the Pearl River Delta. Early identification and intervention of PTSD symptoms in post-traumatic patients are important for the prevention of PTSD.