创伤后应激障碍神经生物学机制研究进展

背景 已知多种因素可引起创伤后应激障碍(post-traumatic stress disorder,PTSD),然而其发生的神经生物学机制尚不明确. 目的 综述目前PTSD神经生物学机制的研究进展. 内容 从动物模型和恐惧记忆形成的不同阶段出发,阐述PTSD的神经生物学机制. 趋向 PTSD形成涉及多种神经生物学改变,然而这些改变如何引起PTSD尚需进一步研究.     

产后创伤后应激障碍评估工具的研究进展

对目前国内外产后创伤后应激障碍测评工具包括创伤后应激障碍清单—平民版(PCL-C)、创伤后应激障碍清单-V(PCL-5)、修订版事件冲击量表(IES-R)、创伤后应激障碍症状量表(PSS)、围产期创伤后应激障碍问卷(PPQ)、城市分娩创伤量表(BiTS)的编制时间、信效度、翻译及修订情况、适应性等方面进行描述和比较,分...     

创伤后应激障碍的影响因素及早期护理干预

创伤后应激障碍作为一种反应性精神障碍,其相关影响因素包括创伤性事件、个体易感因素和社会因素三大方面.做好创伤后应激障碍的观察和评估,早期实施心理干预、对症护理等有利于减少创伤后应激障碍的发生,提高患者生存质量.     

创伤后应激障碍的影响因素及早期护理干预

创伤后应激障碍作为一种反应性精神障碍，其相关影响因素包括创伤性事件、个体易感因素和社会因素三大方面。做好创伤后应激障碍的观察和评估，早期实施心理干预、对症护理等有利于减少创伤后应激障碍的发生，提高患者生存质量。     

重大突发公共卫生事件背景下医护人员创伤后应激障碍研究进展

本研究回顾和归纳了新型冠状病毒肺炎疫情大流行下国内外医护人员创伤后应激障碍的流行概况、影响因素及干预策略,并对未来我国重大公共卫生事件下医护人员创伤后应激障碍研究领域进行展望。     

创伤后应激障碍的护理体会

本院ICU从1999年至2002年5月,在收治各类创伤病人中并发应激障碍患者共11例,治疗效果满意。现将护理体会介绍如下。1临床资料11例中男性8例,女性3例;年龄19岁～42岁,平均年龄32岁。经治疗均愈痊,其中药物治疗最长达1个月,出院时症状消失。经随访3月,均未复发。2护理体会2.1早期发现、提高认识。本组患者伤情严重,除了加强生命体征及必要的监护手段外,应特别注意观察神志、表情、行为、言语、睡眠等异常表现,并应认真加以分析。患者进入ICU后,初期表现为强烈的求生欲望,均情绪稳定,配合救治。以后面对疾病的漫长和痛苦,手术换药的疼痛和创…     

创伤后应激障碍

自“9·11”事件以来,SARS、印度洋海啸以及汶川大地震等灾难性事件相继发生。大批幸存者在躯体创伤逐渐康复的同时,普遍出现了不同程度的心理疾病。其中,创伤后应激障碍（posttraumatic stress disorder,PTSD）是最常见的一种。PTSD是指个体在暴露于无法承受的创伤事件后,形成了与创伤有关的插入性思维和记忆,持续性逃避创伤相关刺激,并表现出持续增长的警觉状态。     

高速公路车祸创伤后应激障碍18例临床分析

目的对创伤后应激障碍(PTSD)患者的高发人群、发病特点做回顾性研究,以达到早期诊断、早期治疗。方法对1523例高速公路创伤患者中,经《国际疾病分类》(第十版)ICD-10明确诊断为PTSD的18例患者的性格、性别、受教育程度、临床表现、治疗、康复时间做回顾性研究。结果18例患者中高中以下文化程度15例,占83.33%;高中以上文化程度3例,占16.67%。性格偏内向者14例,占77.78%;性格偏外向者4例,占22.22%。PTSD患者主要表现为抑郁、言语不能、躁狂、歇斯底里、记忆减退、判断力减退、持续恶梦、警觉性提高等精神障碍。治疗后缓解时间男性组2～18d,女性组3～25d;文化程度高中以下组8～25d,高中以上组2～16d;性格偏内向组7～12d,性格偏外向组3～9d。结论本文提示文化受教育程度低的人群比受教育程度高的人群,女性比男性,性格偏内向人群比性格偏外向人群更易发生PTSD,且患病经治疗缓解时间延长。     

创伤后应激障碍的神经生物学机制

创伤后应激障碍又称PTSD,应激原往往具有异常惊恐或灾难性质,如残酷的战争、被强暴、地震、凶杀等,常引起个体极度恐惧、害怕、无助之感。事件本身的严重程度,暴露于这种精神创伤性情景的时间,接触或接近生命威胁情境的密切程度,人格特征、个人经历、社会支持、躯体心理素质等是影响病程迁移的因素。发病多数在遭受创伤后数日至半年内出现。大多数病人1年内恢复,少数病人持续多年不愈而成为持久的精神病态。[第一段]     

ICU护士创伤后应激障碍的调查分析

目的了解ICU护士创伤后应激障碍症状的发生情况,为保持和促进ICU护士的身心健康提供依据。方法整群抽取济南市3所三级甲等综合医院4个ICU 170名护士,采用创伤后应激障碍症状清单平民版及自制ICU创伤事件量表对其进行问卷调查。结果 ICU创伤事件总发生情况平均得分为1.10±0.49,对ICU护士精神影响程度平均得分为2.05±0.53。ICU护士创伤后应激障碍症状阳性率为21.76%。不同工作年限ICU护士创伤后应激障碍症状水平存在统计学差异(P<0.05)。创伤后应激障碍症状总分及各维度分别与12项ICU创伤事件的影响程度得分及总分呈正相关(r=0.201~0.489,均P<0.05)。结论 ICU护士创伤后应激障碍发生率较高,护理管理者应高度重视ICU护士的身心健康,有针对性地进行心理辅导与咨询。     

母亲声音刺激在早产儿护理中的研究进展

系统综述母亲声音刺激对早产儿喂养、生命体征、神经行为发育、心肺功能及生长发育等的影响,并指出其发展局限性和前景,以期为今后的研究提供参考。     

优势内容递增教育法在早产儿家长培训中的效果评价

目的评价"优势内容递增教育法"对早产儿家长的培训效果,为早产儿家长的健康教育培训提供参考。方法对55名早产儿家长进行培训内容需求调查,从其最希望获取的优势内容开始进行培训,收集培训前后家长的知识得分及对培训内容、培训方式的满意度。结果早产儿家长知识得分从培训前的(11.44±4.15)分提高到培训后的(19.25±0.73)分,差异有统计学意义(P0.01);10项课程内容认可度达到58.18%及以上;96.36%的家长对此次培训总体满意。结论应用"优势内容递增教育法"对早产儿家长进行培训成效明显,可提高家长的早产儿护理能力。     

Fluoxetine in post-traumatic stress disorder

Fluoxetine was given to five nonveteran patients with post-traumatic stress disorder (PTSD). The maximum doses ranged from 20 to 80 mg/day, and treatment was continued for between 8 and 32 weeks. In contrast to published reports of other drugs, which were noted to improve only the intrusive symptoms of PTSD, fluoxetine was associated with marked improvement of both intrusive and avoidant symptoms. Facilitative effects of fluoxetine were noted on trauma-focused psychotherapy in two adult victims of childhood sexual trauma. In part, these effects were related to modulating effects of the drug upon the intensity of core PTSD symptoms. Serotonergic drugs appear to hold promise for the treatment of PTSD.This work was conducted in the Departments of Psychiatry and Psychology, Duke University, Durham, N.C.     

智护训练对早产儿视听能力的影响

目的探讨智护训练对早产儿视听能力的影响。方法将160例早产儿随机分为对照组和干预组各80例。对照组给予早产儿常规护理,干预组在此基础上自出生第1天起即实施智护训练,包括视觉、听觉及视听结合训练,在院期间由专职护士一对一训练,主要道具是红色海绵球和新生儿沙锤;出院后由家属继续训练,持续至出生后6个月。结果出生后1个月、3个月和6个月,干预组对视觉刺激敏感、听觉正常的比例显著高于对照组(P0.05,P0.01)。结论早期智护训练有助于早产儿建立各种反射,提高对外界刺激的反应性和视听能力。     

乳腺癌患者性生活状况评估工具的研究进展

国内外尚无权威统一的乳腺癌患者性生活状况的评估工具,对乳腺癌患者的性生活评价缺乏相应的"金标准"。对国内外应用于乳腺癌女性患者性生活状况的评估工具进行综述,旨在为开展乳腺癌患者性生活相关研究提供参考。     

Familial abuse and post-traumatic stress disorder

Previous study of a sample of 149 adolescent runaways showed that youths who left home because of familial physical abuse were more likely than youths who left home for other reasons to report symptomatology consistent with the diagnostic criteria of Post-Traumatic Stress Disorder (PTSD). The literature suggests that stress reactions, such as PTSD, are not direct responses to stressors, such as familial abuse. Rather, these relationships are mediated by factors which influence a person's ability to cope with stressors. This paper reports the results of exploring two factors which influence coping ability: (1) perceptions of control over the stressor, and (2) the availability of intrafamilial social support. Using information from the same sample of 149 adolescent runaways, we compared youth who left home because of familial physical abuse to youth who did not on the basis of these two coping resources. Results show that victims of familial physical abuse are significantly more likely than are other runaways to believe that they could not have changed or controlled the events that led to their running. Further, the intrafamilial social support systems of these young victims are highly dysfunctional. Study findings support the contention that factors which decreased the coping ability of runaway victims of familial abuse heightened the probability of their developing Post-Traumatic Stress Disorder.     

Myocardial infarction and post-traumatic stress disorder

Studies concerning the development of a post-traumatic stress disorder related to severe illness are scarce. The confrontation with myocardial infarction may be a very stressful event. Twenty-three patients consecutively admitted for first myocardial infarction were studied. After two years 1 of 18 survivors had been suffering from a partial post-traumatic stress disorder. Similarities and differences in the psychological reactions following potential traumatic events are discussed.     

Violence,trauma, and post-traumatic stress disorder among women drug users

In order to examine the association between the experience of violent events, trauma, and post-traumatic stress disorder among women drug users, 105 women in treatment for addictive disorders were interviewed. One hundred four of the study participants reported trauma in 1 or more of 14 categories of traumatic events, 59% of whom reported symptoms consistent with a diagnosis of posttraumatic stress disorder. Among those with PTSD, 97% reported one or more violent traumas as compared with 73% of those without PTSD. The likelihood of PTSD was strongly associated with the number of violent traumas reported by a woman. Women in recovery from drug addiction are likely to have a history of violent trauma and are at high risk for post-traumatic stress disorder. Screening for PTSD among women with an addictive disorder should become part of the diagnostic and treatment routine.