脑出血患者自杀意念风险因素分析及干预研究

Risk factors analysis and intervention study of suicidal ideation in patients with cerebral hemorrhage

目的 探讨脑出血患者自杀意念相关风险因素及合理情绪疗法的预防作用。方法 选取脑出血患者100例,通过路径的方法收集患者一般信息、出血量、出血位置,入院时应用美国国立卫生研究院中风量表(NIHSS)评分评估脑出血严重程度,采用焦虑自评量表(SAS)评定焦虑程度,通过自杀意念量表(SSI)评定患者是否存在自杀意念,通过logistic回归分析自杀意念的独立危险因素,采用卡方检验检测自杀意念患者在合理情绪疗法干预组和非干预组中的分布。结果 NIHSS评分和SAS评分是出血性卒中患者的自杀意念的独立危险因素(OR=9.336,95%CI=2.972~29.328,P<0.001;OR=1.674,95%CI=1.231~2.276,P=0.001)。合理情绪疗法干预组的自杀意念发生率显著低于非干预组(11.1%比55.6%;OR=0.600,95%CI=0.101~3.548,P=0.012)。结论 对于脑出血后伴有焦虑情绪的患者及早采用合理情绪疗法,可显著减少患者自杀意念的产生。

Objective To explore the risk factors of suicide ideation and the preventive effect of rational emotive therapy in patients with hemorrhagic stroke. Methods According to the inclusion criteria,100 patients with hemorrhagic stroke were consecutively enrolled from Yijishan Hospital of Wannan Medical College.We collected the demographic data,volume of hematoma,location of hematoma and National Institutes of Health Stroke Scale (NIHSS) on admission.Anxiety was assessed with Self-Rating Anxiety Scale (SAS) and suicidal ideation was evaluated by Scale for Suicide Ideation (SSI). Results NIHSS score and SAS score were positively correlated with suicide ideation of patients with hemorrhagic stroke ( OR=9.336,95%CI=2.972-29.328,P<0.001;OR=1.674,95%CI=1.231-2.276, P =0.001 ,respectively).Rational emotive therapy was associated significantly with reduced incidence of suicide ideation ( OR=0.6,95%CI=0.101-3.548,P =0.012). Conclusions For patients with anxiety after hemorrhagic stroke,early use of rational emotive therapy can significantly reduce the incidence of suicidal ideation.