创伤后截肢患者急性应激障碍相关危险因素分析

Analysis of risk factors related to acute stress disorder in patients with post-traumatic amputation

目的探讨创伤后截肢患者发生急性应激障碍(ASD)的影响因素,为临床进行有效干预提供依据。方法选取2016年6月至2021年1月106例创伤后截肢患者为研究对象,根据是否发生ASD将其分为ASD组和非ASD组。通过斯坦福急性应激反应问卷(SASRQ)、汉密尔顿焦虑量表(HAMA)、视觉模拟疼痛评分(VAS)、心理弹性量表、社会支持评定量表进行评测,分析影响ASD发生的相关因素。结果ASD发病率为58.49%(62/106)。与非ASD组比较,ASD组SASRQ及各维度得分更高,而心理弹性量表得分及各维度得分,以及社会支持量表得分更低,差异有统计学意义(P<0.05)。多因素分析结果显示:性别、经济收入、HAMA和VAS、心理弹性水平和社会支持水平是创伤后截肢患者发生ASD的影响因素(P<0.05)。结论创伤后截肢患者ASD发生率较高,应及时干预、有效疏导。

Objective To explore the influencing factors of acute stress disorder(ASD)in patients with post-traumatic amputation and to provide evidence for effective clinical intervention.Methods A total of 106 post-traumatic amputation patients from June 2016 to January 2021 were selected for the study.The patients were divided into the ASD and non-ASD group according to whether ASD occurred or not.Stanford acute stress response questionnaire(SASRQ),hamilton anxiety scale(HAMA),visual analog pain score(VAS),connor-davidson resilience scale and social support rate scale were used to evaluate and analyze the related factors influencing the occurrence of ASD.Results The prevalence of ASD was 58.49%(62/106).Compared with those of the non-ASD group,the ASD group had a higher SASRQ score and each dimension score,lower connor-davidson resilience scale score and each dimension score,and lower social support rate scale score,the differences were statistically significant(P<0.05).The results of the multifactorial analysis showed that gender,economic income,HAMA and VAS scores,level of connor-davidson resilience scale and level of social support rate scale were the influencing factors of ASD in patients with post-traumatic amputation(P<0.05).Conclusion The incidence of ASD in the post-traumatic amputation patients is high,and timely intervention and effective diversion should be provided.