严重胸部钝性伤患者近期生活质量评价及相关影响因素分析  

Evaluation and influential factors of early life quality of patients with severe blunt chest trauma

作　　者：王小文[1] 汪治臻 都定元[2] 向小勇[1] 赵兴吉[2] 

机构地区：[1]重庆医科大学附属第一医院胸外科,400016 [2]重庆市急救医疗中心,重庆市急救医学研究所

出　　处：《中华创伤杂志》2014年第2期132-135,共4页Chinese Journal of Trauma

基　　金：重庆市科委自然科学基金重点资助项目（CSTC2012jjB10021）;重庆市卫生局医学科学技术研究重点资助项目（2010-1-52）

摘　　要：目的 分析严重胸部钝性伤（severe blunt chest trauma,sBCT）患者伤后近期生活质量、创伤后应激障碍（posttraumatic stress disorder,PTSD）及其相关影响因素. 方法 收集2011年1月-2011年12月符合标准的sBCT患者的人口统计学和临床资料,采用简明健康状况调查量表（short-form-36 health survey,SF-36）和事件影响量表（impact of event scale-revised,IES-R）分别对患者伤后1,3,6个月的生活质量与PTSD情况进行评价.伤后影响生活质量的相关危险因素采用Logistic回归分析. 结果 本研究共纳入107例患者,最终完成6个月随访的患者83例.伤后6个月SF-36评分仍较低,且有1/3患者处于中、重度PTSD症状.影响伤后生活质量的主要危险因素有年龄、ISS≥20分、合并颅脑损伤、合并脊柱和骨盆损伤、伤后并发症及PTSD. 结论 sBCT患者伤后近期生活质量较差,通过识别特异性危险因素而进行早期干预可能有利于改善患者的生活质量.Objective To assay the early quality of life and posttraumatic stress disorder （PTSD） and relating influential factors in patients with severe blunt chest trauma （sBCT）. Methods Demographic and clinical data of sBCT patients treated between January 2011 and December 2011 were collected. Early quality of life and PTSD symptom level at posttraumatic months 1, 3, and 6 were ana- lyzed by using short form 36 health survey （SF-36） and impact of event scale-revised （IES-R） respec- tively. Furthermore, logistic regression analysis was performed to identify the risk factors associated with quality of life of the patients. Results A total of 107 patients were included in the study. Ultimately, 83 patients were available to the 6-month follow-up. A low score for SF-36 remained at posttraumatic 6 months and one-third of the 83 patients sustained mild or severe PTSD symptoms. Major influential factors to posttraumatic quality of life included age, ISS ≥ 20, combined craniocerebral injury, combined spinal and pelvic injuries, posttraumatic complications, and PTSD. Conclusions Early quality of life in sBCT patients is poor. Therefore, the early intervention with identification of specific risk factors is con- tributive to better quality of life.

关 键 词：胸部损伤 应激障碍 创伤性 吻合术 外科 

分 类 号：R655[医药卫生—外科学]