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[地震后转运伤员创伤后应激障碍严重程度的影响因素分析]

[Analysis on factors affecting the severity of post-traumatic stress disorder in transferred casualty after Earthquake].

作者信息

Gao Xin-Xue, Kuang Li, Liu Wan-Ting, Lou Dan-Dan, Li Da-Qi, Ai Ming, Chen Jian-Mei, Li Xue-Mei, Zhao Zheng-Zhong

机构信息

The Center of Mental Health, the First Affiliated Hospital Chongqing Medical University, Chongqing 400016, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2009 Aug;30(8):793-6.

Abstract

OBJECTIVE

To investigated the related factors which affecting the severity degrees of post-traumatic stress disorder (PTSD) in transferred casualty after Wenchuan Earthquake.

METHODS

Taking PTSD symptoms self-assessment scale (PCL-C) to involve 386 wounded who suffered 40 days after the earthquake disaster, from 11 hospitals and were transferred to Chongqing city. Multi-stage cluster sampling method was used. 354 valid questionnaires were recovered to explore the relevant factors affecting the severity on the symptoms of PTSD.

RESULTS

This survey contains 354 subjects, with male 154 (43.6%), female 200 (56.4%), age 43.76 +/- 21.22, nation alities: Han people 236 (66.7%), Qiang people 114 (32.2%), others 4 (1.1%), and marriage status as unmarried 92 (26.1%), married 253 (71.7%), others 9 (2.2%). The wounded women PTSD have more serious symptoms than men, and there were differences between them in repeated and disturbing dreams of this stressful experience (t = 2.46, P = 0.014), a strong sense of psychological suffering annoyance (t = 2.02, P = 0.044), having difficulty concentrating (t = 2.04, P = 0.042), being "super-alert" (t = 2.465, P = 0.014) etc, also in the total scores (t = 2.489, P = 0.013) (P < 0.05). The PTSD symptoms of wounded degree in who had been buried in Earthquake were more serious than those not been buried. There were significant differences between them in the items as: avoid thinking about or talking about a stressful experience (t = 2.661, P = 0.008), avoid activities or situations that could recall the stressful experience (t = 2.705, P = 0.007), trouble remembering important parts of a stressful experience (t = 2.775, P = 0.006), feeling emotionally numb or being unable to have loving feelings for those close to you (t = 3.017, P = 0.003), feeling as if your future will somehow be cut short (t = 2.979, P = 0.003) and total scores (t = 3.175, P = 0.002). The wounded that witnessed someone be buried or died in earthquake, in PTSD symptoms, were more serious than those without. In the items of feeling distant or cut off from other people, feeling emotionally numb or being unable to have loving feelings for those close to you, feeling irritable or having angry outbursts, there were significant difference (P < 0.05 - 0.01). There were significant differences among the average score of the three core symptoms (F = 3.350, P < 0.001), among the three core symptoms as well as between the three core symptoms and total score respectively.

CONCLUSION

There were differences in the severity degrees of PTST in transferred casualty under different exposed conditions. Correlations were also found between each of the symptoms.

摘要

目的

探讨汶川地震后转运伤员创伤后应激障碍(PTSD)严重程度的相关影响因素。

方法

采用创伤后应激障碍症状自评量表(PCL-C),对震后40天从11所医院转至重庆市的386名伤员进行调查。采用多阶段整群抽样法。共回收有效问卷354份,探讨影响PTSD症状严重程度的相关因素。

结果

本次调查共354例对象,其中男性154例(43.6%),女性200例(56.4%),年龄43.76±21.22岁,民族:汉族236例(66.7%),羌族114例(32.2%),其他4例(1.1%),婚姻状况:未婚92例(26.1%),已婚253例(71.7%),其他9例(2.2%)。女性伤员PTSD症状较男性严重,在对此次应激经历的反复和困扰性梦境(t=2.46,P=0.014)、强烈的心理痛苦烦恼感(t=2.02,P=0.044)、注意力难以集中(t=2.04,P=0.042)、“过度警觉”(t=2.465,P=0.014)等方面以及总分(t=2.489,P=0.013)上差异有统计学意义(P<0.05)。经历过被掩埋的伤员PTSD症状较未被掩埋者严重,在避免思考或谈论应激经历(t=2.661,P=0.008)、避免能回忆起应激经历的活动或情境(t=2.705,P=0.007)、难以回忆起应激经历的重要部分(t=2.775,P=0.006)、情感麻木或对亲近的人没有爱的感觉(t=3.017,P=0.003)、感觉未来会以某种方式缩短(t=2.979,P=0.003)及总分(t=3.175,P=0.002)等项目上差异有统计学意义。目睹他人被掩埋或死亡的伤员PTSD症状较未目睹者严重,在感觉与他人疏远或隔绝、情感麻木或对亲近的人没有爱的感觉、易怒或发脾气等项目上差异有统计学意义(P<0.05~0.01)。三个核心症状平均分之间差异有统计学意义(F=3.350,P<0.001),三个核心症状之间以及三个核心症状与总分之间差异均有统计学意义。

结论

不同暴露情况下转运伤员的PTSD严重程度存在差异,各症状间也存在相关性。

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