消化道穿孔术后患者创伤后应激障碍的危险因素

Risk factors of post-traumatic stress disorder in patients with gastrointestinal perforation

目的探讨消化道穿孔术后患者出现创伤后应激障碍(PTSD)的危险因素。方法本研究纳入2020年1月~2023年3月83例消化道穿孔患者为研究对象,术后1个月采用创伤后应激障碍量表平民版测验(PCL-C)进行PTSD筛查,根据筛查结果划分为PTSD组以及无PTSD组。比较两组患者一般资料以及相关量表,采用logistic回归分析法分析PTSD与一般资料及相关量表的关系。结果83例消化道穿孔患者术后发生PTSD 22例;PTSD组年龄、穿孔直径、住院时间、合并睡眠障碍均显著高于无PTSD组,(P<0.05),两组心理弹性水平、文化程度、应对方式差异具有统计学意义(P<0.05),两组性别、婚姻、居住地差异无统计学意义(P>0.05);年龄≥60岁、穿孔直径>2cm、合并睡眠障碍、低心理弹性水平、消极应对是消化道穿孔术后PTSD的危险因素。结论消化道穿孔术后PTSD较高,穿孔直径大、合并睡眠障碍等是PTSD的危险因素,应重视消化道穿孔术后PTSD的筛查与预防。

Objective To investigate the risk factors of post-traumatic stress disorder(PTSD)after gastroin-testinal perforation.Methods Eighty-three patients with gastrointestinal perforation from January 2020 to March 2023 were selected as the study subjects.PTSD screening was conducted one month after surgery using the Posttraumatic Stress Disorder Inventory Civilian Version Test(PCL-C).They were divided into PTSD group and non PTSD group ac-cording to the screening results.The general information of two groups of patients,as well as the correlation scale were compared.The relationship between PTSD and general data,as well as correlation scale were analyzed using logistic regression analysis.Results Postoperative PTSD occurred in 22 out of 83 patients with gastrointestinal perforation;The age,perforation diameter,hospital stay,and concomitant sleep disorder in the PTSD group were significantly higher than those in the non PTSD group(P<0.05).There were statistically significant differences in mental resilience level,educational level and coping style between the two groups(P<0.05).There was no statistically significant differ-ence in gender,marriage,or place of residence between the two groups(P>0.05).Age≥60 years old,perforation diameter>2cm,associated with sleep disorders,low levels of mental resilience,and negative coping are risk factors for postoperative PTSD after digestive tract perforation surgery.Conclusion PTSD is relatively high after digestive tract perforation surgery,and the Large piercing diameter,combined with sleep disorders,etc are a risk factor for PTSD.Psychological intervention after digestive tract perforation surgery should be emphasized.