心理干预和帕罗西汀治疗海上灾害创伤后应激障碍的临床观察  

Clinical Observation of Psychological Intervention and Paroxetine on Patients with Posttraumatic Stress Disorders after Maritime Disasters

作　　者：贺顺龙[1] 谢培增[2] 汪先兵[2] 刘剑[2] 白金喜[2] 刘妲[2] 周峰[2] 朱晖 

机构地区：[1]解放军421医院神经内科,广东广州510318 [2]解放军421医院神经外科,广东广州510318 [3]解放军422医院急诊科

出　　处：《华南国防医学杂志》2011年第3期249-251,共3页Military Medical Journal of South China

基　　金：全军医学科学技术"十一五"课题(06MB174)

摘　　要：目的探讨海上灾害严重创伤后应激障碍(posttraumatic stress disorder,PTSD)的临床特点,观察心理干预、鲁米那(luminal)和帕罗西汀(paroxetine)的治疗效果。方法 153例海上灾害严重创伤后PTSD病人采用心理干预、鲁米那和帕罗西汀的治疗。按PTSD自评量表(PTSD checklist-civilian version,PCL-C)和90项症状清单(SymptomChecklist90,SCL-90),评定PTSD恢复程度和临床治疗结果。结果 153例伤员中,按PCL-C评分,治疗后PTSD症状逐渐减轻,治疗后30天、60天和90天正常率分别为35%、93%和99%;按SCL-90评分,治疗后30天、60天、90天痊愈率分别为24%、93%和99%,治疗后60天痊愈率显著高于治疗后30天(P<0.05)。结论海上灾害创伤因素多,伤病员数量多、创伤重和PTSD发生率高。早期采用心理干预和鲁米那、帕罗西汀治疗可明显降低海上灾害严重创伤后PTSD的阳性率,提高治愈率。Objective To study the clinical characteristics of posttraumatic stress disorders（PTSD） after maritime disasters and observe the therapeutic effects of psychological intervention,luminal and paroxetine.Methods A total of 153 PTSD patients with severe injury after maritime disasters accepted psychological intervention and luminal and paroxetine treatment.The recovery status of PTSD and clinical treatment effects were evaluated by PTSD checklist-civilian version（PCL-C） and Symptom Checklist 90（SCL-90）.Results PTSD symptoms in 153 patients were gradually relieved according to the PCL-C scores,and the normal rate was 35%,93% and 99% on the 30th,60th and 90th day respectively after treatment.According to the SCL-90 scores,the cure rate was 24%,96% and 99% on the 30th,60th and 90th day respectively after treatment,and the cure rate was significantly higher in the 60th day than in the 30th day after treatment（P0.01）.Conclusion The maritime disasters have special clinical features including various causes of injures,large quantity of patients,severity of injury and high incidence of PTSD.Early psychological intervention and treatment with luminal and paroxetine can significantly reduce the positive rate and raise the cure rate of PTSD.

关 键 词：海上灾害 严重创伤 创伤后应激障碍 心理干预 鲁米那 帕罗西汀 

分 类 号：R741[医药卫生—神经病学与精神病学] R395.2[医药卫生—临床医学]