Leeds Institute of Health Sciences, Leeds medical school, University of Leeds, Leeds, UK.
Department of Psychology and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
BMJ Paediatr Open. 2021 Jul 16;5(1):e001147. doi: 10.1136/bmjpo-2021-001147. eCollection 2021.
Children undergoing surgery and their parents are at risk of developing post-traumatic stress reactions. We systematically reviewed the literature to understand the prevalence of this issue, as well as potential risk factors.
We conducted a systematic review and meta-analysis, using PubMed, PsycInfo, Web of Science and Google Scholar, with searches conducted in February 2021. Papers were included if they measured post-traumatic stress in children and/or parents following paediatric surgery and were excluded if they did not use a validated measure of post-traumatic stress. Data were extracted from published reports.
Our search yielded a total of 1672 papers, of which 16 met our inclusion criteria. In meta-analysis, pooled studies of children estimated an overall prevalence of 16% meeting criteria for post-traumatic stress disorder post surgery (N=187, 95% CI 5% to 31%, I=80%). After pooling studies of parents, overall prevalence was estimated at 23% (N=1444, 95% CI 16% to 31%, I=91%). Prevalence rates were higher than those reported in the general population. Risk factors reported within studies included length of stay, level of social support and parental mental health.
There is consistent evidence of traumatic stress following surgery in childhood which warrants further investigation. Those delivering surgical care to children would benefit from a raised awareness of the potential for post-traumatic stress in their patients and their families, including offering screening and support.
接受手术的儿童及其父母有发生创伤后应激反应的风险。我们系统地回顾了文献，以了解这一问题的普遍性，以及潜在的风险因素。
我们进行了系统的回顾和荟萃分析，使用了 PubMed、PsycInfo、Web of Science 和 Google Scholar，检索时间为 2021 年 2 月。纳入的论文需测量儿童和/或父母在小儿手术后的创伤后应激情况，如果未使用创伤后应激的验证性测量方法，则将其排除在外。数据从已发表的报告中提取。
我们的搜索共产生了 1672 篇论文，其中 16 篇符合我们的纳入标准。在荟萃分析中，对儿童的汇总研究估计手术后符合创伤后应激障碍标准的儿童总体患病率为 16%（N=187，95%CI 5%至 31%，I=80%）。汇总父母的研究后，总体患病率估计为 23%（N=1444，95%CI 16%至 31%，I=91%）。患病率高于一般人群报告的患病率。研究中报告的风险因素包括住院时间、社会支持水平和父母的心理健康。
有一致的证据表明儿童手术后存在创伤后应激，这需要进一步调查。为儿童提供手术护理的人员将受益于提高对其患者及其家庭发生创伤后应激的潜在风险的认识，包括提供筛查和支持。
