烧伤后感染与创伤后应激障碍的关联性及临床预测因素  

Correlation between post-burn infection and post-traumatic stress disorder and analysis of clinical predictors

作　　者：祝天华 郜天田 黄定基 杨洪 ZHU Tianhua;GAO Tiantian;HUANG Dingji;YANG Hong(Department of Burns,Nanyang Nanshi Hospital,Nanyang 473000,China)

机构地区：[1]南阳南石医院烧伤科,473000

出　　处：《中国健康心理学杂志》2025年第3期367-370,共4页China Journal of Health Psychology

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20230960)。

摘　　要：目的:探讨烧伤后感染与创伤后应激障碍(PTSD)的关联性,分析烧伤后发生PTSD的预测因素。方法:选取某院2022年2月-2024年2月收治的烧伤患者96例,分为PTSD组和无PTSD组,其中PTSD组36例,无PTSD组60例。收集统计两组年龄、性别、受教育时间、婚姻状况、烧伤面积、烧伤部位、烧伤原因、是否感染等一般资料,采用心理弹性问卷(CD-RISC)评估患者心理弹性,采用伤残接受度量表(ADS)评估患者伤残接受度。Logistics回归分析烧伤患者发生PTSD的危险因素。结果:PTSD组比无PTSD组烧伤面积更大、CD-RISC评分及ADS评分更低(t=9.005,6.072,8.584;P<0.001)。PTSD组烧伤部位头面部最多,无PTSD组烧伤部位躯干及四肢最多(χ^(2)=22.578,P<0.05)。烧伤后感染与烧伤面积呈正相关,与CD-RISC评分、ADS评分呈负相关(r=0.586,-0.391,-0.265;P<0.05)。感染、烧伤面积、烧伤部位(头面部)与PTSD呈正相关,CD-RISC评分、ADS评分与PTSD呈负相关(r=0.312,0.666,0.436,-0.527,-0.683;P<0.05)。Logistics回归分析结果显示感染(OR:1.385,95%CI:1.074~1.787)、烧伤面积(OR:1.198,95%CI:1.087~1.322)、烧伤部位(头面部)(OR:1.550,95%CI:1.178~2.039)是发生PTSD的危险因素,CD-RISC评分(OR:0.672,95%CI:0.521~0.876)、ADS评分(OR:0.629,95%CI:0.460~0.860)是发生PTSD的保护因素(P<0.05)。结论:烧伤后感染与患者PTSD发生有相关性,感染、烧伤面积、烧伤部位、CD-RISC评分、ADS评分是烧伤后PTSD发生的预测因素,医护人员可针对这些因素进行适当干预,以减轻患者PTSD。Objective:To investigate the association between post-burn infection and post-traumatic stress disorder(PTSD),and to analyze the predictive factors of PTSD after burn.Methods:A total of 96 burn patients admitted to our hospital from February 2022 to February 2024 were divided into PTSD group and non-PTSD group,including 36 PTSD group and 60 non-PTSD group.General data such as age,gender,time of education,marital status,burn area,burn location,burn cause,and infection were collected and analyzed in the two groups.Psychological resilience was assessed by using the mental resilience questionnaire(CD-RISC),and disability acceptance Scale(ADS).Logistics regression analysis of the risk factors of PTSD in burn patients.Results:The burn area of PTSD group was larger than that of non-PTSD group,and the scores of CD-RISC and ADS were lower(t=9.005,6.072,8.584;P<0.001).The most burned parts were head and face in the PTSD group,and trunk and limbs in the non-PTSD group(χ^(2)=22.578,P<0.05).Postburn infection was positively correlated with burn area,and negatively correlated with CD-RISC score and ADS score(r=0.586,-0.391,-0.265;P<0.05).Infection,burn area and burn site(head and face)were positively correlated with PTSD,while CD-RISC score and ADS score were negatively correlated with PTSD(r=0.312,0.666,0.436,-0.527,-0.683;P<0.05).Logistics regression analysis showed that infection(OR:1.385,95%CI:1.074~1.787),burn area(OR:1.198,95%CI:1.087~1.322)and burn site(head and face)(OR:1.550,95%CI:1.178~2.039)were risk factors for PTSD,and CD-RISC score(OR:0.672,95%CI:0.521~0.876)and ADS score(OR:0.629,95%CI:0.460~0.860)were protective factors for PTSD(P<0.05).Conclusion:Postburn infection is correlated with PTSD.Infection,burn area,burn site,CD-RISC score and ADS score are predictive factors of PTSD after burn.Medical staff can make appropriate intervention according to these factors to alleviate PTSD.

关 键 词：创伤后应激障碍 烧伤 感染 心理弹性 伤残接受度 

分 类 号：R395.6[哲学宗教—心理学]