颈椎骨折脱位患者内固定术后发生创伤后应激障碍的相关因素

Related Factors of Post-Traumatic Stress Disorder in Patients with Cervical Fracture and Dislocation After Internal Fixation

目的分析颈椎骨折脱位患者内固定术后创伤后应激障碍(PTSD)发生状况及其影响因素。方法选取2019年1月至2020年12月在郑州市骨科医院接受内固定术治疗的156例颈椎骨折脱位患者为研究对象。所有患者术后均接受定期随访。于随访3个月时,采用PTSD检查量表平民版(PCL-C)评估患者PTSD发生状况并分组;采集入选者一般资料并比较,经多因素logistic回归分析找出可能导致颈椎骨折脱位患者内固定术后发生PTSD的影响因素。结果156例颈椎骨折脱位患者内固定术后有57例发生PTSD,发生率为36.54%。发生PTSD组受教育程度、家庭关怀度、伤残接受度及自我超越量表(STS)评分与未发生PTSD组比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,受教育程度为初中及以下、家庭关怀度低下、伤残接受度低下均可能是颈椎骨折脱位患者内固定术后发生PTSD的危险因素,STS评分高是其保护因素(P<0.05)。结论颈椎骨折脱位患者内固定术后PTSD发生风险较高,可能受受教育程度为初中及以下、家庭关怀度低下、伤残接受度低下及自我超越水平的影响。

Objective To analyze the occurrence and influencing factors of post-traumatic stress disorder(PTSD)in patients with cervical fracture and dislocation after internal fixation.Methods A total of 156 patients with cervical fracture and dislocation treated with internal fixation in Zhengzhou Orthopedic Hospital from January 2019 to December 2020 were selected as the research objects.All the patients were followed up regularly after operation.After 3 months of follow-up,the occurrence of PTSD was assessed by PTSD checklist-civilian version(PCL-C),and the patients were divided into two groups.The general data of the selected candidates were collected and compared.Multivariate logistic regression analysis was used to find out the influencing factors that might lead to PTSD after internal fixation in patients with cervical fracture and dislocation.Results Of the 156 patients with cervical fracture and dislocation after internal fixation,57 cases developed PTSD,and the incidence rate was 36.54%.There were statistical differences in the educational level,family care,disability acceptance and self-transcendence scale(STS)score in PTSD group and non PTSD group(P<0.05).Multivariate logistic regression analysis shows that the education level of junior middle school and below,low family care and low disability acceptance might be the risk factors of PTSD in patients with cervical fracture and dislocation after internal fixation,and the high STS score was the protective factor(P<0.05).Conclusion Patients with cervical fracture and dislocation have a high risk of PTSD after internal fixation,which may be affected by the educational level of junior middle school and below,low family care,low disability acceptance and self-transcendence level.