创伤性颅脑损伤伴胫骨骨折患者反刍性沉思与创伤后成长的相关性

Correlation between ruminant meditation and post-traumatic growth in patients with traumatic head injuryand tibial fracture

目的观察创伤性颅脑损伤(TBI)伴胫骨骨折患者创伤后成长(PTG)水平,分析患者反刍性沉思与PTG的关系。方法选取郑州市第九人民医院2019-04—2020-07收治的81例TBI伴胫骨骨折患者为研究对象,采用创伤后成长量表(PTGI)评估患者PTG水平并分组;设计基线资料调查问卷,采集患者基线资料,比较反刍性沉思情况[采用事件相关反刍性沉思问卷(ERRI)评估],分析TBI伴胫骨骨折患者反刍性沉思与PTG的关系。结果81例TBI伴胫骨骨折患者中32例(39.51%)PTG水平低下;PTG水平低下组文化程度、社会支持度评分、反刍性沉思倾向评分均低于PTG水平正常组,差异有统计学意义(P<0.05);组间其他资料比较差异无统计学意义(P>0.05)。经二元回归分析后建立多元回归模型行多元回归分析,结果显示文化程度低、社会支持度低、反刍性沉思倾向低均是TBI伴胫骨骨折患者PTG水平低下的影响因素(OR>1,P<0.05),其中反刍性沉思倾向低带来的影响最为显著,可能作为独立危险因素;相关性分析显示,TBI伴胫骨骨折患者反刍性沉思与PTG水平呈正相关(r>0,P<0.05)。结论TBI伴胫骨骨折患者的PTG水平普遍低下,可能受反刍性沉思倾向影响,临床应重视TBI伴胫骨骨折患者PTG水平的监测观察,并早期予以反刍性沉思倾向低的患者针对性干预,可能对提高患者PTG水平有积极意义。

Objective To observe the post-traumatic growth(PTG)level of patients with traumatic brain injury(TBI)and tibial fracture,to analyze the relationship between ruminant meditation and PTG.Methods A total of 81 TBI patients with tibial fractures treated in our hospital from April 2019 to July 2020 were selected as the research objects.The post-traumatic growth scale(PTGI)was used to assess the PTG level of patients and divided them into groups;designed a baseline data survey questionnaire,collected and compared patients’baseline data,focused on comparing the ruminant meditation of patients(assessed with the event-related ru⁃mination meditation questionnaire(ERRI)),analyzed the relationship between ruminant meditation and PTG in patients with TBI with tibial fracture.Results Among 81 TBI patients with tibial fractures,32 had low PTG levels,accounting for 39.51%;the educa⁃tional level,social support score,and ruminant meditation score of the low PTG level group were lower than those of the normal PTG level group,and the difference was statistically significant(P<0.05);compared other data between groups,the difference was not sta⁃tistically significant(P>0.05);after binary regression analysis,a multiple regression model was established and multiple regression analysis was performed,the results showed that low education,low social support,and low propensity for ruminating contemplation were all influencing factors for low PTG levels in patients with TBI with tibial fractures(OR>1,P<0.05).Among them,the influence of low ruminant contemplation was the most significant,which might be an independent risk factor;correlation test results showed that ruminant meditation in patients with TBI with tibial fracture was positively correlated with PTG level(r>0,P<0.05).Conclusion The PTG level of patients with TBI with tibial fractures is generally low,which may be affected by ruminant contemplation.Clinically,the monitoring and observing of PTG levels in patients with TBI and tibial fractures need to be focused on,and providing earlytargeted intervention for patients with low ruminant contemplation,which may have a positive significance in improving patients’PTG levels.