颅脑损伤并发精神病性障碍影响因素分析  

Analysis of influencing factors of craniocerebral injury complicated with psychotic disorders

作　　者：薛艺红[1] 李蕊[1] 赵杰[1] 何锋[1] 李秋昉[1] 赵春玲[1] Xue Yihong;Li Rui;Zhao Jie;He Feng;Li Qiufang;Zhao Chunling(Xinxiang Central Hospital,Xinxiang 453000,Henan,China)

机构地区：[1]新乡市中心医院,河南新乡453000

出　　处：《临床心身疾病杂志》2019年第2期141-144,共4页Journal of Clinical Psychosomatic Diseases

基　　金：新乡市科技创新人才项目(编号2015007053).

摘　　要：目的探讨颅脑损伤并发精神病性障碍影响因素,为临床护理干预提供依据.方法将130例颅脑损伤患者根据是否并发精神病性障碍分为观察组(并发精神病性障碍)52例,对照组(无精神病性障碍)78例,比较两组患者的性别、年龄、文化程度、受伤原因、入院时格拉斯哥昏迷评分、损伤部位、合并颅内感染与否等相关资料,对观察组并发精神病性障碍影响因素进行多因素Logistic回归分析,并统计观察组患者干预效果.结果本组130例颅脑损伤患者中精神病性障碍发生率为40.0%,其中躁狂症占36.5%、抑郁症占23.1%、焦虑症占13.5%、其他占26.9%.观察组入院时格拉斯哥昏迷评分≤8分、合并低氧血症、伤后昏迷检出率及损伤部位中颅内血肿、额叶损伤、脑干损伤检出率均显著高于对照组(P<0.05或0.01),文化程度显著低于对照组(P<0.01);多因素Logistic回归分析显示,格拉斯哥昏迷评分≤8分、损伤部位、低氧血症是影响颅脑损伤患者并发精神病性障碍的独立危险因素(P<0.01).出院后随访3个月观察组总有效率为96.2%.结论颅脑损伤并发精神病性障碍与颅脑损伤部位、入院时格拉斯哥昏迷评分及低氧血症密切相关,积极予以对症治疗及综合护理干预能有效改善患者的预后.Objective To explore the influencing factors of craniocerebral injury complicated with psychotic disorders,and provide evidence for clinical nursing intervention.Methods 130 cases of patients with craniocerebral injury were selected and divided into the observation group(n=52,complicated with psychotic disorders)and the control group(n=78,without psychotic disorders).Compare the gender,age,education level,cause of injury,Glasgow coma score,site of injury,whether or not combined with intracranial infection of the two groups.Multivariate logistic regression analysis was performed on the influencing factors of the psychiatric disorder in the observation group,and the intervention effect of the observation group was statistically analyzed.Results The incidence of psychotic disorders in this group of 130 patients with craniocerebral injury was 40.0%,including 36.5%for mania,23.1%for depression,13.5%for anxiety,and 26.9%for others.Glasgow coma score≤8 points,combined hypoxemia,post-injury stun detection rate and intracranial hematoma,frontal lobe injury,and brainstem injury were significantly higher in the observation group than those in the control group(P<0.05 or 0.01),the educational level was significantly lower than that in the control group(P<0.01).Multivariate logistic regression analysis showed that Glasgow coma score≤8,injury site,and hypoxemia were independent risk factors for psychotic disorders in patients with craniocerebral injury(P<0.01).The total effective rate of the observation group was 96.2%after 3 months of follow-up after discharge.Conclusions Craniocerebral injury complicated with psychiatric disorders is closely related to the location of craniocerebral injury,Glasgow coma score and hypoxemia at admission.Active symptomatic treatment and comprehensive nursing intervention can effectively improve the prognosis of patients.

关 键 词：颅脑损伤 精神病性障碍 器质性精神障碍 并发症 影响因素 护理干预 

分 类 号：R651.15[医药卫生—外科学] R749.1[医药卫生—临床医学]