Schweitzer I, Rosenbaum M B, Sharzer L A, Strauch B
Plast Reconstr Surg. 1985 Jul;76(1):97-103. doi: 10.1097/00006534-198507000-00016.
Fifty consecutive patients admitted for replantation surgery received a psychiatric evaluation. In 28 percent of the patients there was evidence of preaccident psychopathology. Fifty-four percent of the patients reported a recent stressful life event predating the accident. Fifty-four percent of the patients were assessed as having an adverse postoperative emotional reaction. The presence of preaccident psychopathology, evidence of family dysfunction, and a history of a recent stressful life event were positively linked with an adverse postoperative emotional reaction. In addition, patients with hand or arm replants were significantly less likely to require a psychiatric intervention than patients with leg replants. The psychological processes pertaining to the replantation journey are described in five stages: the preaccident period, the initial response, the stage of uncertainty, the recognition of loss, and acceptance and reintegration. Finally, the role of a liaison psychiatrist on a replantation unit is outlined and further research is strongly urged.
连续50例接受再植手术的患者接受了精神科评估。28%的患者有事故前精神病理学证据。54%的患者报告在事故前有近期应激性生活事件。54%的患者被评估为术后有不良情绪反应。事故前精神病理学的存在、家庭功能障碍的证据以及近期应激性生活事件的病史与术后不良情绪反应呈正相关。此外，与腿部再植患者相比，手部或手臂再植患者需要精神科干预的可能性显著降低。与再植过程相关的心理过程分为五个阶段：事故前期、初始反应期、不确定期、意识到损失期以及接受与重新融入期。最后，概述了联络精神科医生在再植病房的作用，并强烈敦促进一步开展研究。
