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中国飞行员急性应激障碍的药物治疗共识:德尔菲研究。

Consensus on the pharmacological treatment of acute stress disorder in Chinese pilots: a Delphi study.

机构信息

Department of Military Medical Psychology, The Fourth Military Medical University, Xi'an, 710032, China.

Air Force Hospital of Southern Theater Command, Guangzhou, 510000, China.

出版信息

BMC Psychiatry. 2023 Sep 8;23(1):664. doi: 10.1186/s12888-023-05145-5.

Abstract

BACKGROUND

Appropriate medication is very important for pilots with acute stress disorder. Improper medication can not only affect the physical and mental health of the pilots but can also endanger flight safety. Hence, we aimed to quickly and effectively relieve symptoms and restore cognitive function by forming a consensus of Chinese experts on the pharmacological treatment of acute stress disorder in pilots using the Delphi method.

METHODS

Relevant literature was searched to enumerate the current status of pharmacological treatment of acute stress disorder in pilots, followed by two rounds of expert consultation and discussion according to the listed status of the survey using the Delphi method. A descriptive statistical method was used to analyze the basic information, authority coefficients, concentration of opinions, and survey items of the experts to develop a consensus on the pharmacological treatment of acute stress disorder in pilots.

RESULTS

A total of 16 experts in psychiatry, pharmacology, and aerospace medicine from different provinces and cities across China were invited for consultation. The recovery rate of the two rounds of consultation was 100%, and the expert authority coefficients were 0.897 and 0.906, respectively. Kendall's coefficient of concordance of indicators at all levels was 0.564-0.594 (p < 0.01). Based on the number of votes received, alprazolam tablets (16), eszopiclone tablets (15), and lorazepam tablets (14) were recommended for the treatment of excitatory psychomotor symptoms of acute stress disorder; paroxetine tablets (15) and sertraline tablets (15) were available for psychomotor depressive symptoms; olanzapine tablets (15), olanzapine orally disintegrating tablets (14), and quetiapine fumarate tablets (14) were selected for psychotic symptoms.

CONCLUSIONS

This study formed a consensus on rapid and effective pharmacological treatment for different symptoms of acute stress disorder pilots, which provides a reference for clinical treatment.

摘要

背景

急性应激障碍飞行员的恰当用药非常重要。用药不当不仅会影响飞行员身心健康,还会危及飞行安全。因此,我们采用德尔菲法,召集国内航空医学、精神医学和药学专家,就飞行员急性应激障碍的药物治疗形成专家共识,旨在快速、有效地缓解症状,恢复认知功能。

方法

检索相关文献,列举目前飞行员急性应激障碍的药物治疗现状,采用德尔菲法,根据调查现状进行两轮专家咨询和讨论。采用描述性统计学方法,对专家的基本情况、权威系数、意见集中程度和调查条目进行分析,制定飞行员急性应激障碍药物治疗共识。

结果

共邀请全国 16 名精神医学、药学和航空航天医学领域的专家参与咨询。两轮咨询的回收率均为 100%,专家权威系数分别为 0.897 和 0.906。各级指标 Kendall 协调系数为 0.564~0.594(p<0.01)。根据得票情况,推荐阿普唑仑片(16 票)、艾司佐匹克隆片(15 票)、劳拉西泮片(14 票)治疗急性应激障碍兴奋型精神运动性症状;推荐帕罗西汀片(15 票)、舍曲林片(15 票)治疗精神运动性抑郁症状;推荐奥氮平片(15 票)、奥氮平口崩片(14 票)、富马酸喹硫平片(14 票)治疗精神病性症状。

结论

本研究针对不同症状的急性应激障碍飞行员达成了快速、有效的药物治疗共识,为临床治疗提供了参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77b/10492406/1b6c678e7a0b/12888_2023_5145_Fig1_HTML.jpg

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