Roccia Fabio, Dell'Acqua Alessandro, Angelini Giuseppe, Berrone Sid
Division of Maxillofacial Surgery and Department of Neuroscience, Psychiatric Section, S. Giovanni Battista Hospital, Turin, Italy.
J Craniofac Surg. 2005 May;16(3):355-60. doi: 10.1097/01.scs.0000157028.44315.b8.
Interest in the psychiatric consequences of trauma and the subsequent surgical intervention has been increasing steadily; therefore, the authors assessed the prevalence of acute symptoms of stress in patients who experienced a craniomaxillofacial injury. Fifty patients between the ages of 18 and 65 years were evaluated and assigned a score using the Injury Severity Scale (ISS). Within 48 hours of surgery (T0) and at 3 months after surgery (T1), the authors administered the Davidson Trauma Scale (DTS) to assess post-traumatic symptoms, Spielberger's State-Trait Anxiety Inventory (STAI) to assess symptoms of anxiety, and Zung's Self-rating Depression Scale (SDS) to assess depressive symptoms. Of the subjects, 44% (22 patients at T0) had acute symptoms of stress, and 26% (13 patients at T1) had post-traumatic stress symptoms. The statistical association between demographic variables was significant only for gender, especially for women. There was a significant correlation between the psychopathologic variables and trauma-specific symptoms at both T0 and T1; the same was true for the ISS at T0. Eight of the 13 patients with positive DTS results at 3 months had aesthetic and functional sequelae that might have served as reminders of the traumatic event. It is not only necessary to restitutio ad integrum the anatomy and function, but also to provide psychiatric support for patients experiencing psychiatric symptoms caused by traumatic events.
对创伤及后续外科手术干预所带来的精神后果的关注一直在稳步增加;因此,作者评估了颅颌面损伤患者中急性应激症状的发生率。对50名年龄在18至65岁之间的患者进行了评估,并使用损伤严重程度评分(ISS)对其进行评分。在手术后48小时内(T0)以及手术后3个月(T1),作者使用戴维森创伤量表(DTS)评估创伤后症状,使用斯皮尔伯格状态-特质焦虑量表(STAI)评估焦虑症状,使用zung自评抑郁量表(SDS)评估抑郁症状。在这些受试者中,44%(T0时为22名患者)有急性应激症状,26%(T1时为13名患者)有创伤后应激症状。人口统计学变量之间的统计关联仅在性别方面具有显著性,尤其是女性。在T0和T1时,心理病理变量与创伤特异性症状之间均存在显著相关性;T0时的ISS情况也是如此。在3个月时DTS结果呈阳性的13名患者中,有8名存在美学和功能后遗症,这些后遗症可能会成为创伤事件的提醒。不仅有必要恢复解剖结构和功能,还需要为因创伤事件出现精神症状的患者提供精神支持。