上消化道出血患者急性应激障碍影响因素的病例对照研究  

A case-control study on the influencing factors of acute stress disorder in patients with upper gastrointestinal hemorrhage

作　　者：孙欢 于子荞 王春梅[1] SUN Huan;YU Zi-qiao;WANG Chun-mei(Department of Basic Nursing,School of Nursing,Tianjin Medical University,Tianjin 300070,China;Department of Gastroenterology,Tianjin Fifth Central Hospital,Tianjin 300450,China;Department of Anesthesiology,The Second Hospital,Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学护理学院基础护理学教研室,天津300070 [2]天津市第五中心医院消化内科,天津300450 [3]天津医科大学第二医院麻醉科,天津300211

出　　处：《天津医科大学学报》2022年第1期91-94,共4页Journal of Tianjin Medical University

摘　　要：目的:探讨上消化道出血患者急性应激障碍的影响因素。方法:运用病例对照研究法,选取天津市第五中心医院消化内科同期住院的270例患者为研究对象。通过斯坦福急性应激反应问卷(SASRQ)的调查,将发生急性应激障碍(ASD)的144例患者作为病例组,将未发生ASD的126例患者作为对照组。由专业人员对研究对象进行SASRQ、匹兹堡睡眠质量指数量表(PSQI)和疼痛视觉模拟评分尺(VAS)和一般资料的调查。比较病例组与对照组之间上述指标的差异。对ASD的影响因素进行Logistic回归分析。结果:与对照组相比,病例组性别、年龄、婚姻状况、文化程度、主要照顾者关系、出血量、出血次数、出血诱因、疼痛程度、是否伴有其他症状、睡眠质量、是否恐惧是导致上消化道出血患者发生ASD的重要影响因素;多因素Logistic回归分析显示:性别(OR=0.435,95%CI:0.202~0.938)、文化程度(OR=0.573,95%CI:0.419~0.784)、出血诱因(OR=0.014,95%CI:0.000~0.410)、疼痛程度(OR=0.442,95%CI:0.221~0.886)、睡眠质量(OR=0.531,95%CI:0.379~0.744)为ASD的保护因素,年龄(OR=1.861,95%CI:1.119~3.095)、主要照顾者(OR=1.871,95%CI:1.172~2.987)、是否伴有其他症状(OR=33.219,95%CI:6.069~81.383)是ASD的危险因素。结论:年龄、主要照顾者关系、是否伴有其他症状是导致上消化道出血患者发生ASD的重要危险因素。Objective:To investigate the influencing factors of acute stress disorder in patients with upper gastrointestinal bleeding.Methods:Case-control study was used to select 270 patients hospitalized in department of Gastroenterology of Tianjin Fifth Central Hospital during the same period as the research object.By the Stanford Acute Stress Response Questionnaire(SASRQ),144 patients with acute stress disorder(ASD)were selected as case group,and 126 patients without ASD were selected as control group.The subjects were investigated by professionals with SASRQ,Pittsburgh Sleep Quality Index(PSQI),visual analogue scale(VAS)and general data.The differences of the above indicators between the case group and the control group were compared.The influencing factors of ASD were analyzed by Logistic regression.Results:Compared with the control group,gender,age,marital status,educational level,primary caregiver relationship,bleeding volume,bleeding frequency,bleeding inducement,pain degree,whether accompanied by other symptoms,sleep quality and fear in the case group were important influencing factors for ASD in patients with upper gastrointestinal bleeding.Multivariate Logistic regression analysis showed that:gender(OR=0.435,95%CI:0.202-0.938),education level(OR=0.573,95%CI:0.419-0.784),bleeding cause(OR=0.014,95%CI:0.000-0.410),pain degree(OR=0.442,95%CI:0.221-0.886),sleep quality(OR=0.531,95%CI:0.379-0.744)were protective factors of ASD.Age(OR=1.861,95%CI:1.119-3.095),primary caregivers(OR=1.871,95%CI:1.172-2.987),and whether accompanied by other symptoms(OR=33.219,95%CI:6.069-81.383)were risk factors for ASD.Conclusion:Age,primary caregiver relationship and whether accompanied by other symptoms are important risk factors for ASD in patients with upper gastrointestinal hemorrhage.

关 键 词：上消化道出血 急性应激障碍 影响因素:病例对照 

分 类 号：R573.2[医药卫生—消化系统]