地震对重灾区与一般灾区高中生的心理冲击

已有研究指出,在经历地震等重大灾难性事件后,人们易出现创伤后应激障碍(PTSD)、焦虑、抑郁、睡眠问题等身心障碍[1-3],在儿童青少年身上也有类似表现[4].一项针对希腊地震后学生创伤后应激障碍与焦虑症状的研究发现,离震中越近的学生出现的症状越多[5].本文比较地震对受灾程度不同两地高中生的心理冲击.     

汶川地震受灾民众创伤后成长及其影响因素

目的:考察经历汶川地震这一重大创伤性事件后极重灾区之一的彭州板房区受灾民众的创伤后成长及其影响因素。方法:使用IES-R、PTGI中文修订版,以及自编的调查问卷,对彭州板房区2403名受灾民众进行调查,回收有效问卷2104份。结果:被试的PTSD症状及地震对个体造成的客观和主观影响越大,其创伤后成长得分也越高;但地震造成的主、客观影响在PTSD症状进入回归模型后变得不再显著或显著性水平降低。结论:地震后个体PTSD症状是预测创伤后成长最重要的因素。     

精神分裂症抑郁症状

抑郁虽是各类抑郁症的核心症状，但也可见于精神分裂症患者。据文献报道，抑郁与分裂的并存相当普遍．Johnson[1]研究表明．抑郁症状在精神分裂症的病程中是常见的．而且可以在病程的任何时期出现．不管是初发、复发，有无用药史，甚至在缓解期使用长效制剂维持治疗的病人也会发生。据统计，精神分裂症患者件有抑郁的发生率可高达30～50％[2]。Johnson研究发现．首次发病的精神分裂症在住院时或在住院前二个月抑郁的发生率为50％，而复发病人在住院时抑郁的发生率为35％，停药的精神分裂症病人抑郁的发生率为24％[3]。对这类抑郁症状，文献…     

震后不同地区初中生的抑郁水平及创伤后症状

目的:比较汶川地震后受灾程度不同地区初中生的抑郁水平及创伤后症状,并探讨其影响因素。方法:采用青少年生活事件量表(ASLEC)、自尊量表(SES)、儿童版事件冲击量表修订版(CIES-R)、儿童抑郁量表(CDI)测量工具,对来自受灾程度不同地区的341名初中生进行测查。结果:受灾严重地区的初中生在PTSD症状上显著高于受灾一般地区的初中生,但在抑郁症状上显著低于受灾一般地区的初中生;在回归分析中,发现自尊和生活事件的学习因子对抑郁和创伤后症状的预测作用较大,但两者的预测作用相反。结论:不同受灾地区初中生的抑郁水平和创伤后症状不同,受灾严重的地区抑郁症状较轻,但PTSD症状较重。     

警惕抑郁症的残留症状

随着医疗水平的提高,抑郁症经过抗抑郁药物等手段．的治疗,大多能获得较好的疗效,总体治疗有效率在60％-70％之间。然而,不少病人往往满足于短期疗效,当抑郁症急性发作时痛苦的情绪体验已经减轻,对生活、工作的兴趣已经恢复,躯体疼痛等不适症状渐渐消退,睡眠已经明显好转,不少病人就片面地认为“病已痊愈”,过早地停止药物等治疗。     

震后3个月不同安置社区中轻度受灾者的创伤后应激症状和抑郁症状

目的:比较汶川地震后不同安置社区中受灾群众的创伤后应激障碍(post traumatic stress dis-order,PTSD)和抑郁症状的差异及相关因素。方法:对四川彭州市新兴镇两个聚居点的全部居民约2000人进行了普查,抽取其中信息完整的轻度受灾群众209人,其中原址安置居民100人,迁址安置居民109人。采用自编灾后基本情况调查问卷、事件冲击量表修订版(Impact of Event Scale-Revised,IES-R)、流调用抑郁自评量表(Center for Epidemiological Survey Depression Scale,CES-D)测量围创伤期变量、PTSD症状和抑郁症状。结果:迁址安置组IES-R得分和CES-D得分均高于原址安置的受试[(37.21±15.12)vs.(32.82±14.96),P=0.036;(22.49±8.95)vs.(19.52±8.86),P=0.017];在不同组受试的回归分析中,震后人际关系变化对PTSD症状在迁址组中有负向的预测作用,而在原址组中预测作用为正[(β=-0.277)vs.(β=0.176)];财物损失对PTSD症状在迁址组中没有显著预测作用,但在原址组中亦有负性预测作用[(未进入方程)vs.(β=-0.326)]。结论:不同的安置方式会对创伤后应激症状和抑郁症状造成影响,迁址安置的群众在PTSD和抑郁症状上都更为明显。     

大学生生活事件和睡眠质量的关系

慢性心理应激和睡眠质量关系研究是我国心理学服务民生、改善民生的一项紧迫课题。前期对压力、压力源等重要心理应激对睡眠质量的影响及其内在机制进行了综述[1]。本文探讨大学生生活事件与睡眠质量之间的关系,以期从生活事件的视角找到改善大学生睡眠质量的途径。     

哮喘患儿的焦虑症状测评分析

哮喘是儿童时期最常见的慢性疾病[1] 。近年来发病率呈上升趋势[2 ] 。反复发作的哮喘严重影响了患儿的身体健康 ,患儿也常伴有不同程度的心理问题。本文采用“特质焦虑问卷” (ＳＴＡＩ,Ｆｏｒｍｙ -Ⅱ ,简称Ｔ -ＡＩ) [3] ,对我院呼吸科诊治的部分哮喘患儿进行测评 ,并与同龄在校儿童进行对比 ,以期探讨哮喘发作程度和持续时间的相关性。对象　哮喘组 :样本来源于 1998年6月至 1999年 3月我院呼吸科诊治的 2 0名哮喘患儿 ;哮喘发作严重程度 ,按照1994年全国小儿呼吸道疾病学术会议对患儿哮喘严重程度进行评分 :非急性期发作患儿 1分 ;急性…     

前列腺癌患者血清PSA、Hcy和IGF-I测定的临床意义

前列腺癌（prostate cancer,Pca）和前列腺增生（benignprostate hyperplasia,BPH）为中老年男性常见的泌尿系统疾病。近年来,随着我国人民生活的改善,环境污染和饮食结构的改变,该病在我国的发病率逐年升高[1]。由于Pca的早期症状出现不十分显著,而出现症状时往往已发生转移[2]。目前在临床上应用血清学辅助诊断的项目主要是PSA,     

护士抑郁症状与特质应对、角色认知及控制感的相关研究

抑郁症状对个体心理社会功能的影响几乎可以和抑郁障碍相比[1] ,有效地控制抑郁症状不仅有利于提高个体成功的人际交往、保持放松状态以及快乐感 ,还会间接影响到员工的工作绩效和企业生产率[2 ,3] 。已有研究表明[4 ] ,角色认知是影响工作压力的一重要变量 ,它既直接作用于员工的工作压力 ,又通过控制感认知间接地发挥作用 ,即随着角色冲突和角色模糊的减少 ,控制感的增加 ,工作压力相应减少 ,为此 ,角色认知与控制体验也是联系个体压力应对和组织应激源的重要中介变量。目前 ,有研究表明[5- 7] ,通过减少组织应激源 ,如工作再设计、明确工…     

汶川大地震伤员的救治

汶川大地震是破坏性最强、波及范围最广、救灾难度最大的一次地震，大量的地震伤病员需要紧急救治。我院作为重灾区最大的一所综合性医院，在短时间内收治了大量的地震伤病员，主要来自北川、安县、平武等重灾区，伤员大多为各种骨折伤，但因骨科病区无法接收如此大量伤员，故除专科伤员外，耳鼻咽喉科还收治89例骨伤病员。短时间（2d）内收治大量本专业和非本专业伤员，实属罕见，我科总结了这次救治中的经验和教训，现报告如下。     

Sense of community and depressive symptoms among older earthquake survivors following the 2008 earthquake in Chengdu China

This study examined the impact of an earthquake as well as the role of sense of community as a protective factor against depressive symptoms among older Chinese adults who survived an 8.0 magnitude earthquake in 2008. A household survey of a random sample was conducted 3 months after the earthquake and 298 older earthquake survivors participated in it. The results showed that earthquake‐associated distress had a direct effect on depression controlling for coping, informal support, and sense of community. The results also showed that the effect of earthquake‐associated distress is contingent upon the level of sense of community. The findings highlighted the role of individuals' sense of community as a protective factor against traumatic experiences and suggested that attempts to build trust and form a sense of belonging to the new community among older earthquake survivors would help them reduce distress and facilitate a smooth recovery. © 2011 Wiley Periodicals, Inc.     

地震救援中现场截肢的探讨

目的探讨地震救援中现场截肢手术适应证、手术方法及伦理问题。方法映秀镇地震救援中现场截肢2例共3个肢体，采用局部麻醉，截肢平面靠近压迫物。术后补充等张盐水，补液速度1．5L／h，静脉滴注5％碳酸氢钠溶液150mL。口服头孢克肟胶囊，400mg顿服。结果截肢后2例患者均未出现严重并发症，次日送后方医院行二次截肢。结论灾难救援中现场截肢必须综合考虑，严格掌握适应证，必要的截肢可以挽救伤员生命。     

Reflections on the Christchurch earthquake

Background and Objectives The city of Christchurch in New Zealand suffered a series of major earthquakes during 2010 and 2011. These resulted in significant damage and loss of life. The impact of the earthquakes on New Zealand Blood Service is reviewed in the context of emergency planning and preparedness. Impact assessment The requirement for blood and blood components was low and easily met from within existing stocks. The anticipated influx of donors was well managed avoiding unnecessary build-up of blood components and consequent wastage. The Christchurch Blood Centre was closed for a number of days following each major event. Contingency arrangements for supply to Christchurch and other hospitals in the region were successfully implemented. Conclusions Pre-existing emergency plans are an essential component of emergency preparedness. These must however be flexible to respond to rapidly changing situations. The blood service plan must be integrated into regional and national response plans. Access to timely and accurate information is an important contributor to effective management.     

Kobe earthquake and reduced sperm motility

We investigated a possible relationship between the Kobe earthquake(January 17, 1995) and the quality of semen. We assessed spermconcentration and motility of 27 male patients who had a concentrationof more than 30 million/ ml and >40% sperm motility within5 months before the earthquake. Twelve male patients from districtswith a magnitude of <4 on the Richter scale showed no differencein sperm concentration and motility before and after the earthquake.Of 15 male patients from districts with a magnitude of >6,five patients whose houses received no damage showed no distinctchanges in sperm concentration and motility. In contrast, 10patients whose houses were partially or completely destroyedshowed significantly (P < 0.001) lower sperm motility afterthe earthquake than before, although no significant differenceof sperm concentration could be observed. Of these latter 10patients, seven could be followed. In six patients, sperm motilitywas restored between 2 and 9 months after the earthquake; thesperm motility in one patient, whose father died a victim ofthe house crash, has not yet recovered. Thus, the acute stressresulting from such a catastrophic earthquake could be a possiblecause of reduced sperm motility.     

Antimicrobial susceptibility of clinical isolates from earthquake victims in Wenchuan

On 12 May 2008, an earthquake measuring 8.0 on the Richter scale struck Wenchuan County, Sichuan, China. Between 12 May and 11 June, 1823 victims were hospitalized in West China Hospital. These patients were severely injured, and most of their wounds were contaminated. Here, the results of bacteriological identification and antibiotic susceptibility testing of 725 non-duplicate isolates from earthquake victims are presented. Gram-negative bacilli were most frequently isolated (71.3%). Only 18.9% of isolates were Gram-positive bacteria; Candida spp. accounted for 9.7%, and Gram-negative cocci for 0.1%. After anaerobic culture, four Clostridium sordellii strains and one Clostridium bifermentans strain were isolated from deep wounds. Specimen culture from earthquake victims revealed a spectrum of pathogens and antibiotic susceptibilities that was different from that usually encountered in West China Hospital, especially concerning methicillin-resistant Staphylococcus aureus , extended-spectrum β-lactamase producers, and multidrug-resistant (MDR) non-fermenting Gram-negative bacilli. The pathophysiology of the injuries in earthquake victims was different from that in the patients who were not earthquake victims. A combination of environmental bacteria with a high proportion of Gram-negative bacteria was often observed in the earthquake victims. Approximately 26% of all earthquake victims were shown to be carriers of MDR microorganisms. Therefore, appropriate microbiological assessment upon admission, and identification of patients to be put in quarantine, is of paramount importance.     

批量地震伤员救治护理的组织管理与体会

"5.12"汶川地震是我国建国以来损失最为惨重,涉及范围最广的一次灾难.灾难事故伤的特点之一就是在没有准备或准备有限的条件下出现大批的伤员,形成伤员流.2008年5月16日至26日,我院对后送至我院的142例地震伤员进行了救治,通过科学的组织管理,收到良好的效果,现报告如下.