急性氨气泄露事件急诊心理干预  

Emergency psychological intervention of acute ammonia leakage event

作　　者：张帅 菅向东[2] 杨开成 张哲 尹婷 金盈 Zhang Shuai;Jian Xiangdong;Yang Kaicheng;Zhang Zhe;Yin Ting;Jin Ying(Emergency Department of Zhangqiu District People's Hospital Affiliated to Jining Medical College,Jinan 250200,China;Department of Poisoning and Occupational Diseases,Emergency Department of Qilu Hospital,Shandong University,Jinan 250012,China)

机构地区：[1]济宁医学院附属章丘区人民医院急诊科,济南250200 [2]山东大学齐鲁医院急诊科中毒与职业病科,济南250012

出　　处：《中华劳动卫生职业病杂志》2022年第1期72-74,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：国家临床重点专科建设项目(2012650);泰山学者建设工程专项经费项目(ts20130911);山东省医药卫生重点实验室(鲁卫科教国合字[2013]49号);2021年济南市卫生健康委员会科技计划项目(2021-2-133);山东省老年医学学会2021年科技攻关立项(LKJGG2021W0609)。

摘　　要：目的分析一起急性氨气泄露事件中急诊开展相关心理干预情况,为应急事件处置提供借鉴。方法于2020年8月,分析山东省济宁医学院附属章丘区人民医院在2019年6月氨气罐车泄漏事件中接诊的65例患者急诊救治情况,收集事件发生后急诊开展心理干预情况,应用《症状自评量表》(SCL-90)评估其焦虑、抑郁状态,根据心理评估结果实施针对性的心理干预,并分析干预有效率。结果65例就诊患者中出现氨气刺激反应者52例,符合轻度中毒者11例,中度中毒者2例。其中发生胸闷、呼吸困难者60例,痰中带血丝者11例,咽痛者58例,声音嘶哑者43例,畏光流泪者28例,视物模糊者13例,恶心、呕吐者18例,肺部干湿性啰音者2例。与刺激反应患者比较,轻、中度中毒患者躯体化、抑郁、焦虑、敌对、恐怖、偏执和消极应对评分较高(P<0.05)。心理干预有效率98.7%。结论群体性公卫事件中急诊心理评估及干预对患者治疗具有一定帮助。Objective To analyze the situation of emergency psychological intervention in an acute ammonia leakage event,and to provide reference for emergency response.Methods In August 2020,the emergency treatment of 65 patients admitted by Zhangqiu District People's Hospital Affiliated to Jining Medical College of Shandong Province in June 2019 in the ammonia tank car leakage incident was analyzed,the psychological intervention in emergency after the incident was collected,the anxiety and depression were evaluated by symptom checklist 90(SCL-90),and targeted psychological intervention was implemented according to the psychological evaluation results,And analyze the intervention efficiency.Results Among the 65 patients,there were 52 cases of ammonia stimulation reaction,11 cases of mild poisoning and 2 cases of moderate poisoning.There were 60 cases of chest tightness and dyspnea,11 cases of bloody sputum,58 cases of sore throat,43 cases of hoarseness,28 cases of photophobia and tears,13 cases of blurred vision,18 cases of nausea and vomiting,and 2 cases of dry and wet rales in the lungs.The scores of somatization,depression,anxiety,hostility,phobia,paranoia and negative coping in patients with mild and moderate poisoning were higher than those in patients with stimulus response(P<0.05).The effective rate of intervention was 98.7%.Conclusion Emergency psychological evaluation and intervention in mass public health events are helpful to the treatment of patients.

关 键 词：中毒事故 氨气泄漏 急性 心理干预 现场卫生学 调查分析 病例报告 

分 类 号：R395.6[哲学宗教—心理学]