术后臂丛神经损伤（BPI）患者的残疾与疼痛与创伤后应激障碍、抑郁和焦虑的关系。
Relationship between disability and pain to post-traumatic stress disorder, depression, and anxiety in patient with postoperative brachial plexus injury (BPI).
机构信息
Departement of Orthopaedic and Traumatology, Faculty of Medicine, Dr. Soetomo General Academic Hospital, Universitas Airlangga, Surabaya, Indonesia.
Departement of Psychiatry, Faculty of Medicine, Dr. Soetomo General Academic Hospital, Universitas Airlangga, Surabaya, Indonesia.
出版信息
Br J Neurosurg. 2021 Jun;35(3):254-258. doi: 10.1080/02688697.2020.1784846. Epub 2020 Jun 30.
BACKGROUND
Orthopedic trauma patients have the risk to experience mental disorders, including depression, anxiety, post-traumatic stress disorder (PTSD), and other mental disorders. However, studies that analyze the relationship between mental disorders in orthopedic trauma patients, especially post-operative brachial plexus injury (BPI), are still difficult to find. This study aims to evaluate the relationship between disability and pain to post-traumatic stress disorder, depression, and anxiety in patient with postoperative BPI.
MATERIALS AND METHODS
It was an observational analysis with cross-sectional design study. Data were collected from July 2019 to September 2019. All subjects were patients of Orthopedics Clinic Dr. Soetomo General Academic Hospital Surabaya. The Disabilities of the Arm, Shoulder, and Hand (DASH) score was used to determine the disability level in patients. Visual Analog Score (VAS) was an instrument for assessing pain scale and mental disorders used Mini International Psychiatry Interview (MINI).
RESULTS
There were 41 subjects met the research criteria, consisted of 10 men (24.39%) and 31 women (75.61%), aged 12-63 years. Based on the status of education, most subjects were graduated from junior/senior high school with 28 subjects (68.29%). The most common cause of BPI was traffic accidents as many as 37 people (90.24%). Mental disorders diagnosed from MINI found ten people (24.39%) were diagnosed with major depression; two subjects (4.87%) had generalized anxiety disorder. The average VAS score was 5.15 and the average DASH score was 52.02. There was no significant difference in VAS scores in the major depression group and PTSD group. However, there was an association between DASH score and depression ( < 0.05). Surprisingly, this study found the risk of suicide among BPI (7.3%) and one person with psychotic disorders (2.43%).
CONCLUSION
The level of disability and pain in orthopedic trauma patients with depression tend to more severe than without depression.
背景
骨科创伤患者有患精神障碍的风险，包括抑郁、焦虑、创伤后应激障碍（PTSD）和其他精神障碍。然而，分析骨科创伤患者，特别是术后臂丛神经损伤（BPI）患者精神障碍之间关系的研究仍然难以找到。本研究旨在评估术后 BPI 患者的残疾和疼痛与创伤后应激障碍、抑郁和焦虑之间的关系。
材料与方法
这是一项观察性分析，采用横断面设计研究。数据收集于 2019 年 7 月至 9 月。所有研究对象均为泗水苏托莫综合学术医院骨科诊所的患者。手臂、肩部和手部残疾（DASH）评分用于确定患者的残疾程度。视觉模拟评分（VAS）是一种用于评估疼痛程度和精神障碍的工具，使用迷你国际精神病学访谈（MINI）。
结果
有 41 名符合研究标准的患者，包括 10 名男性（24.39%）和 31 名女性（75.61%），年龄 12-63 岁。根据教育程度，大多数患者为初中/高中毕业生，有 28 名患者（68.29%）。BPI 最常见的病因是交通事故，有 37 人（90.24%）。通过 MINI 诊断出的精神障碍中，有 10 人（24.39%）被诊断为重度抑郁症；2 人（4.87%）患有广泛性焦虑症。VAS 评分平均为 5.15，DASH 评分平均为 52.02。在重度抑郁症组和 PTSD 组之间，VAS 评分无显著差异。然而，DASH 评分与抑郁之间存在关联（<0.05）。令人惊讶的是，本研究发现 BPI 患者自杀风险为 7.3%，精神病患者为 2.43%。
结论
骨科创伤患者伴有抑郁的残疾和疼痛程度往往比没有抑郁的患者更严重。
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