腹部严重多发性创伤患者术后并发应激障碍的影响因素研究  

Study on the influencing factors of postoperative stress disorder in patients with severe multiple abdominal trauma

作　　者：雷桂花[1] 叶丽珍[1] 王燕[1] 吴小青[1] Lei Guihua;Ye Lizhen;Wang Yan;Wu Xiaoqing(Emergency Trauma Surgery Department, Lishui People′s Hospital, Lishui 323000, China)

机构地区：[1]丽水市人民医院急诊创伤外科,浙江丽水323000

出　　处：《中国医院统计》2020年第2期115-118,共4页Chinese Journal of Hospital Statistics

摘　　要：目的分析腹部严重多发性创伤患者术后并发应激障碍的影响因素。方法对2016年1月至2019年2月在某院实施手术治疗的257例腹部严重多发性创伤患者进行回顾性研究,统计术后应激障碍发生率,探讨应激障碍发生的影响因素。结果257例腹部严重多发性创伤患者术后并发应激障碍64例,发生率为24.9%。多因素分析发现,患者性别(OR=2.646)、受伤时恐惧情绪(OR=2.675)、ISS评分(OR=0.818)、性格(OR=1.536)、严重创伤既往史(OR=2.535)、SSRS评分(OR=0.616)、CD-RISC评分(OR=0.696)、VAS评分(OR=4.549)、HAD评分(OR=1.579)为腹部严重多发性创伤患者术后并发应激障碍的影响因素,差异有统计学意义(P<0.05)。结论对女性、受伤时有恐惧情绪、内向性格、有严重创伤既往史、ISS评分>35分、SSRS评分≤32分、CD-RISC评分≤45分、VAS评分>5分、HAD评分>12分的患者,需辅以心理支持、家庭-社会支持及认知行为干预等相关干预,以减少术后应激障碍发生。Objective To analyze the influencing factors of postoperative stress disorder and the related nursing intervention strategies in patients with severe multiple trauma of the abdomen.Methods Totally 257 patients with severe abdominal trauma who underwent surgery in our hospital from January 2016 to February 2019 were enrolled in the study.The medical records were retrospectively analyzed and the incidence of postoperative stress disorder was statistically analyzed to explore the influencing factors of stress disorder.Results In 257 patients with severe multiple trauma to the abdomen,64 patients had postoperative stress disorder with an incidence rate of 24.9%.Multivariate analysis found that the patients′gender(OR=2.646),fear of injury(OR=2.675),and ISS score(OR=0.818),personality(OR=1.536),previous history of severe trauma(OR=2.535),SSRS score(OR=0.616),CD-RISC score(OR=0.696),VAS score(OR=4.549),and HAD The score(OR=1.579)werethe influencing factors of postoperative complications of stress disorder in patients with severe multiple abdominal trauma,with significant statistical difference(P<0.05).Conclusion Patients with being female,with fear when hurt,introverted personality,history of severe trauma at the time of injury,ISS score>35,SSRS score≤32,CD-RISC score≤45,VAS score>5,or HAD score>12 need to be supplemented with psychological support,family-social support and cognitive behavioral interventions to reduce postoperative stress disorder.

关 键 词：腹部严重多发性创伤 术后应激障碍 影响因素 

分 类 号：R195.1[医药卫生—卫生统计学] R459.7[医药卫生—卫生事业管理]