颅骨缺损后抑郁的危险因素分析

Risk factors of depression after skull defect

目的 分析颅骨缺损后抑郁的独立危险因素。方法 选取颅骨缺损患者80例为研究对象(实验组),另选取颅骨缺损患者家属40例为对照组。使用汉密尔顿抑郁量表(HAMD)进行抑郁评分,根据评估结果将实验组患者分为抑郁组(HAMD评分≥20分)与非抑郁组。采用单因素分析探讨颅骨缺损后抑郁的影响因素,采用Logistic回归分析筛选颅骨缺损后抑郁的危险因素。结果 实验组中抑郁患者34例,非抑郁患者46例,抑郁率为42.5%,对照组中抑郁症患者5例,非抑郁患者35例,抑郁率为12.5%, 2组抑郁率比较,差异有统计学意义(P<0.05)。格拉斯哥昏迷评分(GCS,P<0.001)、性格(P=0.028)、家庭经济状况(P=0.042)、颅骨缺损时间(P=0.002)、颅骨缺损面积(P=0.001)、额叶损伤(P=0.016)、肢体活动障碍(P=0.010)是颅骨缺损后抑郁的影响因素。颅骨缺损的面积>100 cm2(P=0.010)、有肢体活动障碍(P=0.027)、GCS低(P=0.002)是颅骨缺损后抑郁的危险因素。结论 临床应特别关注原发脑损伤重、颅骨缺损面积较大、有肢体活动障碍的颅骨缺损患者的抑郁情况,并在诊疗过程中采取针对性措施。

Objective To analyze the independent risk factors of depression after skull defect. Methods Eighty patients with skull defect were selected as the study objects(experimental group), and 40 family members of patients with skull defect were selected as control group. Hamilton Depression Scale(HAMD) was used to evaluate depression. According to the evaluation results, the patients of the experimental group were divided into depressive group(HAMD score ≥20 points) and non-depressive group. The influencing factors of depression after skull defect were analyzed by univariate analysis, and the risk factors of depression after skull defect were analyzed by Logistic regression. Results In the experimental group, there were 34 depressed patients and 46 non-depressed patients, with a depression rate of 42.5%;in the control group, there were 5 depressed patients, 35 non-depressed patients, with a depression rate of 12.5%. There was statistical significance in depression rate between the two groups(P<0.05). Glasgow Coma Score(GCS, P<0.001), personality(P=0.028), family economic status(P=0.042), skull defect time(P=0.002), skull defect area(P=0.001), frontal lobe injury(P=0.016), limb movement disorder(P=0.010) were the influencing factors of depression after skull defect. The area of skull defect >100 cm~2(P=0.010), limb movement disorder(P=0.027), and low GCS score(P=0.002) were risk factors for depression after skull defect. Conclusion Clinical attention should be paid to depression in skull defect patients with severe primary brain injury, large skull defect area and limb movement disorders, and targeted measures should be taken during diagnosis and treatment.