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蛛网膜下腔出血后患者的心理调适

Psychologic adjustment in patients after subarachnoid hemorrhage.

作者信息

Hütter B O

机构信息

Department of Neurosurgery, University of Technology (RWTH), Aachen Germany.

出版信息

Neuropsychiatry Neuropsychol Behav Neurol. 1998 Jan;11(1):22-30.

PMID:9560825
Abstract

A series of 45 patients after subarachnoid hemorrhage (SAH) with no or only marginal neurologic impairment and 36 patients with chronic obstructive pulmonary disease (COPD) were examined with the German Freiburger Personality Inventory-Revised. Both groups showed a comparable frequency of psychologic impairments, except that the patients with COPD had significantly higher scores in the FPI-R bodily complaints and bodily concern subscales (p < 0.05). In the patients after SAH, loss of motivation (42%), abnormal introversion (40%), increased emotional lability (38%), and strain (31%) were found predominantly. The patients after SAH of unknown origin exhibited psychologic disturbances comparable with patients after aneurysmal SAH. A ruptured aneurysm of the anterior communicating artery did not lead to more psychologic disorders than aneurysms at other locations. Right frontal and right parietal infarctions were associated with significantly less emotional sensitivity (p = 0.013) and bodily concern (p < 0.001). The results demonstrate a substantial discrepancy between the prevalence of psychologic maladjustment and the moderate degree of functional impairment in patients after SAH, which remains to be explained by future research.

摘要

对45例蛛网膜下腔出血(SAH)后无或仅有轻微神经功能损害的患者以及36例慢性阻塞性肺疾病(COPD)患者,使用德国修订版弗赖堡人格量表进行了检查。两组心理障碍的发生率相当,但COPD患者在FPI-R身体不适和身体关注分量表上的得分显著更高(p<0.05)。在SAH后的患者中,主要发现动机丧失(42%)、异常内向(40%)、情绪不稳定增加(38%)和紧张(31%)。不明原因SAH后的患者表现出与动脉瘤性SAH患者相当的心理障碍。前交通动脉破裂的动脉瘤导致的心理障碍并不比其他部位的动脉瘤更多。右侧额叶和右侧顶叶梗死与明显较低的情绪敏感性(p = 0.013)和身体关注(p<0.001)相关。结果表明,SAH后患者心理适应不良的患病率与功能损害的中度程度之间存在显著差异,这有待未来研究进行解释。

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