脑卒中伴运动性障碍患者急性应激障碍与症状群的相关性研究

Study on the relationship between acute stress disorder and symptom group in stroke patients with motor impairment

目的探讨脑卒中伴有运动性障碍患者症状群对急性应激障碍的影响。方法选取2018年10月至2019年8月于华北理工大学神经内外科住院的脑卒中伴运动障碍患者作为研究对象,采用问卷调查法对患者一般资料、颅脑创伤亚量表(brain injury subscale,BIS)、斯坦福问卷(stanford acute stress reaction questionnaire,SARSQ)进行横断面调查。结果本次调查共324例脑卒中伴运动性障碍患者资料,人口特征中文化程度、年龄、运动功能程度、合并功能障碍个数、日常生活能力量表(activity of daily living scale,ADL)分级对急性应激障碍有影响,差异有统计学意义(P<0.05);脑卒中伴有运动性障碍患者急性应激障碍得分为(99.60±13.69)分;症状群中得分由高到低依次为强迫症状(11.35±2.71)分,抑郁特征(7.44±1.86)分,敌意特征(7.23±2.26)分,躯体化(3.69±1.42)分以及精神病特征(2.81±1.09分);相关性分析结果,症状群中躯体化、抑郁、强迫、敌意、精神病分别与急性应激障碍总分及各维度得分呈正相关性(r=0.164、0.355、0.329、0.298、0.279,P均<0.001),症状群与急性应激障碍各个维度也均成正相关关系(P均<0.05);多元线性回归分析结果显示,年龄(回归系数=7.682,95%CI4.930~10.435,P<0.001)、合并功能障碍个数(回归系数=3.937,95%CI0.268~7.605,P=0.036)、抑郁症(回归系数=1.662,95%CI0.727~2.597,P=0.001)对脑卒中患者ASD有影响。结论脑卒中伴有运动性障碍患者急性应激障碍水平为中等偏高,症状群特征较为明显,且与急性应激障碍成正相关关系,医护人员应重点关注脑卒中伴有运动性障碍患者症状群特征及急性应激反应水平,为避免疾病复发,提高生存质量提供针对性干预策略。

Objective To explore the influence of symptom group of stroke patients with exercise disorder on acute stress disorder.Methods Patients with stroke and motor impairment hospitalized in the Department of Neurology and surgery of North China University of technology from October 2018 to August 2019 were selected as the research objects.The general information of patients,brain injury subscale(BIS)and Stanford acute stress reaction questionnaire(SARSQ)were investigated by questionnaire.Results A total of 324 patients with stroke and motor disorders were investigated.The demographic characteristics of education,age,degree of motor function,number of combined dysfunction and Activity Of Daily Living Scale(ADL)grade had effects on acute stress disorder,and the differences were statistically significant(P<0.05).The score of acute stress disorder in stroke patients with motor disorders was(99.60±13.69)points.From the highest to the lowest symptom group,the scores were obsessive symptom(11.35±2.71),depression(7.44±1.86),hostility(7.23±2.26),somatization(3.69±1.42)and psychosis(2.81±1.09).The results of correlation analysis showed that somatization,depression,obsessiveness,hostility and psychosis were positively correlated with the total score of acute stress disorder and the scores of each dimension(r=0.164,0.355,0.329,0.298,0.279,all P<0.05),the symptoms were also positively correlated with all the dimensions of acute stress disorder(all P<0.05).Multiple linear regression analysis showed that age(Regression coefficient=7.682,95%CI:4.930-10.435,P<0.001),the number of combined dysfunction(Regression coefficient=3.937,95%CI:0.268-7.605,P=0.036),depression(Regression coefficient=1.662,95%CI:0.727-2.597,P=0.001)had influence on ASD of stroke patients.Conclusion The level of acute stress disorder in stroke patients with motor impairment is on the high side,and the characteristics of symptom group are obvious,which has a positive correlation with acute stress disorder.Medical staff should pay attention to the characteristics of symptom group and acute stress reaction level of stroke patients with motor impairment,so as to provide targeted intervention strategies to avoid disease recurrence and improve the quality of life.