突发公共卫生事件下急进高原作业的医务人员急性高原反应与心理状况调查  

A study on the acute mountain sickness and mental health of the medical personnel rushing to plateau during public health emergencies

作　　者：田璐[1] 刘毅 田腾飞[1] 潘伟刚[1] 迟勇[1] Tian Lu;Liu Yi;Tian Tengfei;Pan Weigang;Chi Yong(Beijing Key Laboratory of Mental Disorders,National Clinical Research Center for Mental Disorders&National Center for Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China)

机构地区：[1]首都医科大学附属北京安定医院,国家精神疾病医学中心,国家精神心理疾病临床医学研究中心,精神疾病诊断与治疗北京市重点实验室,北京100088

出　　处：《中国医刊》2024年第6期636-639,共4页Chinese Journal of Medicine

基　　金：北京市医院管理中心培育计划(PX2022075)。

摘　　要：目的对突发公共卫生事件下急进高原作业的医务人员的急性高原反应(AMS)与心理状况进行调查,旨在为预防AMS的发生及制订心理干预策略提供科学依据。方法研究对象为2022年8月26日至9月9日紧急进入拉萨市开展医疗支援工作的医务人员。通过AMS临床症状量表将得分0~10分的受试者纳入轻微高原反应(SAMS)组,≥11分的受试者纳入高原反应(AMS)组。调查两组一般资料及情绪状态自评量表、压力感受量表-10(PSS-10)、9项患者健康问卷(PHQ-9)、7项广泛性焦虑障碍量表(GAD-7)评分。结果共调查175名医务人员,其中SAMS组108名,AMS组67名,PHQ-9检出抑郁情绪发生率为49.71%,GAD-7检出焦虑情绪发生率为18.86%。与SAMS组相比,AMS组无高原经历的比例、PHQ-9阳性率、PSS-10评分以及情绪自评量表中疲劳、失眠、食欲减退、担心被感染维度评分均更高,差异有统计学意义(P<0.05)。二元logistic回归分析显示,PSS-10评分(OR=1.091,95%CI 1.020~1.167,P=0.011)及无高原经历(OR=2.614,95%CI 1.047~6.529,P=0.040)是急进高原作业的医务人员发生AMS的危险因素。结论急进高原作业的医务人员容易发生AMS,且存在突出的焦虑抑郁情绪,缺少高原经历及压力感知突出者AMS更显著,有必要对其开展针对性的预防及心理干预。Objective Investigate the acute mountain sickness(AMS)and mental health of medical personnel who rush to plateau during public health emergencies,in order to provide scientific basis for preventing the occurrence of AMS and formulating psychological intervention strategies.Method Grouping the medical personnel who rush to plateau during public health emergencies by the AMS Clinical Symptom Scale,and investigating their general condition,emotional perception questionnaire,perceived stress scale-10,patient health questionnaire-9 items,and generalized anxiety disorder-7.Result A total of 175 people were recruited,including 108 in the SAMS group and 67 in the AMS group.The overall detection rate of depression symptoms was 49.71%,and the detection rate of anxiety symptoms was 18.86%.People without plateau experience were more likely to experience significant AMS(P<0.05),the AMS group had more prominent problems in depression,stress,fatigue,insomnia,decreased appetite,and fear of infection,with significant differences(P<0.05).PSS-10 score(OR=1.091,95%CI 1.020-1.167,P=0.011)and lack of plateau experience(OR=2.614,95%CI 1.047-6.529,P=0.040)are risk factors for AMS among medical personnel who urgently enter plateau by logistic regression.Conclusion Medical personnel rushing to work at plateau are prone to be afflicted with AMS and exhibit prominent depression and anxiety.Those who lack plateau experience and have a strong sense of stress have more significant AMS.It is necessary to carry out targeted prevention and psychological intervention for them.

关 键 词：突发公共卫生事件 急性高原反应 心理健康 医务人员 

分 类 号：R749.92[医药卫生—神经病学与精神病学]