严重脓毒症危重幸存康复患者应激障碍和创伤后应激障碍

Stress Disorder in Survivors of Severe Sepsis and Post-traumatic Stress disorder

目的：调查研究严重脓毒症危重幸存康复患者以及创伤后患者应激障碍以及心理情况,为提高脓毒症患者康复以及创伤后生活水平心理健康提供理论依据。方法：研究对象选取2013年11月-2015年11月期间我院收治的40例严重脓毒症危重幸存康复患者以及40例体检正常人员,将严重脓毒症危重幸存康复患者设为观察组,将正常体检人员设为对照组。分别比较两组受检人员睡眠质量（SRSS）评分、抑郁（SAS）评分、焦虑（SDS）评分以及海马占全脑比重,分别比较两组应激障碍（PTSD）评分中反复重现体验、高警觉症状、回避症状、主观评定、侵袭型症状的评分;将观察组患者按年龄、性别进行分组,比较不同年龄段、性别应激障碍的差异。结果：观察组患者SRSS评分、SAS评分、SDS评分以及PTSD评分均显著低于对照组,有统计学意义（t=26.643,28.692,37.982;P〈0.05）;海马占全脑比重无显著性差异;女性患者PTSD总分、主观评定、高警觉症状、回避症状评分显著高于男性,有统计学意义（t=17.984,18.717,19.509,19.827,14.336,24.346;P〈0.05）;反复重现体验以及侵袭型症状评分差异不显著,无统计学意义。结论：严重脓毒症危重幸存康复患者以及创伤后患者存在较为严重的应激障碍,不良情绪频发,睡眠质量差,同时女性应激障碍显著高于男性。

Objective：To study survivors of severe sepsis and the post-traumatic stress disorder and mood of patients,serving as theory gist for improving post-traumatic living standard and mental health of survivors of sepsis.Methods：A total of 40 cases of survivors of severe sepsis and 40 cases of normal people admitted by our hospital since November 2013 to November 2015 were selected as the object of study.Survivors of severe sepsis were set as observation group,while normal people were set as control group.Objects in two groups were compared for self rating scale of sleep（SRSS）,self-rating anxiety scale（SAS）,self-rating depression scale（SDS）and the proportion of hippocampus in brain.Meanwhile,two groups were compared for scores of repeated experience,high vigilance symptom,avoidance symptom,subjective assessment and invasion symptom in the post-traumatic stress disorder（PTSD）sore.Patients in observation group were divided into several groups based on age and gender,and compared for stress disorder between different age and gender.Results：In the case of SRSS,SAS,SDS and PTSD scores,patients in the observation group gained significantly lower scores than those in the control group（t=26.643,28.692,37.982,24.346;P〈0.05）.There was no significant difference in proportion of hippocampus in brain.Female patients gained dramatically higher scores than male patients in total score of PTSD,subjective assessment,high vigilance symptom,avoidance symptom（t=17.984,18.717,19.509,19.827,14.336,24.346;P〈0.05）,and there was no significant difference in repeated experience and invasion symptom scores（P〉0.05）.Conclusion：According to study,survivors of severe sepsis and post-traumatic patients have severe stress disorder,frequent unhealthy emotion and poor sleep quality.The stress disorder of female patients is higher than that of male patients.