Prevalence and risk factors for posttraumatic stress disorder: a cross‐sectional study among survivors of the Wenchuan 2008 earthquake in China

Background: The impact of the May 2008 Wenchuan earthquake, measuring a massive 8.0 on the surface wave magnitude scale, on public health in China has been significant and multifaceted. In light of extant data on prevalence and risk factors for posttraumatic stress disorder (PTSD) after other natural diasters, we collected data from the Wenchuan earthquake survivors to estimate the prevalence of PTSD and to characterize a range of PTSD risk factors. Methods: A cross‐sectional multicluster sample survey of 446 respondents (201 from the Qiang ethnic‐minority group, 245 the majority Han Chinese group) was conducted in August 2008 in Beichuan county, Sichuan province, a region that was severely affected by the earthquake. In total, 240 households were represented, with a mean of 2.2 respondents per household. Data were collected from structured interviews and the Harvard Trauma Questionnaire (HTQ) and DSM‐IV criteria were used to diagnose PTSD. Results: The prevalence of PTSD was 45.5% (203/446). Low household income, being from an ethnic minority, living in a shelter or temporary house, death in family, and household damage were factors significantly related to increased odds of PTSD. Conclusions: PTSD is common after a major disaster. Postdisaster mental health recovery programs that include early identification, ongoing monitoring, preventive and intervention programs, and sustained psychosocial support are needed for the highest‐risk population, namely, the bereaved, people without incomes and those with serious household damage. These populations may also benefit from governmental and nongovernmental programs that provide social and economic support, as suggested by earlier studies. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

2005-2013年陇南市汶川地震前后黑热病流行特点研究

目的 调查甘肃陇南地区2005-2013年黑热病的发病情况,分析黑热病流行的原因及其受汶川地震的影响。方法 收集2005-2012年黑热病的发病例数,计算发病率,分析地震前后黑热病流行病学特点。结果 在2005-2013年期间,陇南地区黑热病总发病数为825例,年发病率为3.36/10万;黑热病年发病人数在2005-2008年期间有明显上升趋势,2010-2013年期间有明显下降趋势,2008-2010年期间发病人数明显高于其他年份(P ＜ 0.01)。结论 黑热病是陇南地区最常见的人兽共患病,汶川地震所产生复杂的自然和社会环境有利于黑热病流行。因此,本研究充分证明,地震有利于黑热病流行,地震后黑热病应得到更加严格的防控。     

Risk factors for the development of PTSD and depression among child and adolescent victims following a 7.4 magnitude earthquake

Objective. PTSD and major depression occur frequently following traumatic exposure, both as separate disorders and concurrently. Although much of Turkey is under threat of severe earthquakes, risk factors for developing psychiatric disorders among Turkish children have not yet been studied. The aim of the study was to examine risk factors for PTSD and depression develpoment in children. Method. A total of 160 survivors (102 girls and 58 boys) severely impacted by Turkey's 7.4-magnitude quake participated in a psychiatric interview 6–20 weeks after the disaster. The mean age was 14.43. Logistic regression was used to test effects of pre-disaster, disaster-related and post-disaster factors on diagnoses, yielding odds ratios (OR). Results. CAPS indicated that 96 (60%) had PTSD, and psychiatric interview found 49 (31%) with depression. Children diagnosed with PTSD were more likely to have witnessed death (OR=2.47) and experienced an extreme parental reaction (OR=3.45). Children with depression were more likely to be male (OR=4.48), have a higher trait anxiety score (OR=1.12 for every additional point), sustain injury (OR=4.29), and have lost a family member in the quake (OR=10.96). Focusing on the 96 children with PTSD, those with comorbid depression were more likely male, have a higher trait anxiety score, and have lost of family member. Conclusions. Mental health professionals should offer support to children witnessing death or losing a family member in a disaster. The ability of the family to remain calm and reassuring also may be a key factor in preventing PTSD.     

汶川大地震中抗震救灾官兵早期心理健康状态分析

目的探讨2008年5月12日在四川省汶川发生的8.0级大地震中,参与救援的某部官兵的早期心理健康状态及影响因素。方法对169名抗震救灾官兵,采用症状自评量表（SCL-90）和访谈方式进行测查,并对获得的数据进行统计分析。结果169名在四川汶川抗震救灾的官兵,表现出的心理病理症状以躯体化、强迫症状、人际关系敏感、焦虑、抑郁和睡眠障碍为主,心理干预后情况缓解。结论在艰苦、恶劣、危险的环境中高强度、长时间工作,面对血腥、凄惨的震后场面和心情压抑的灾民,心理会受到损害。及时地采取针对性心理干预技术,可减轻或避免“创伤后应激障碍”的发生。     

成批伤员的急诊处理

目的探讨成批外伤伤员急诊处置的原则和意义。方法我院急诊科对2008年5月12日14时28分-5月13日2时28分来院的地震伤员共计189例,按其伤别及伤情程度,分别给予不同的处置措施。结果所有伤员均得到有序、有效的救治,经清创、包扎等简单处置后离院146例,急诊清创缝合术、急诊手术48例,收住院36例,死亡1例（死于重度多发伤）。结论有效的急救训练和急诊管理,有利于提高急诊工作效率,发挥急诊科院前急救最大的救治能力,充分保证了医疗安全。     

汶川地震救援官兵适应不良与社会支持的相关性

目的探讨抗震救援官兵适应不良与社会支持及相关因素的关系,并观察对其实施干预的效果。方法随机抽取146名参加救援官兵和165名非救援官兵进行军人适应不良自评量表和社会支持量表调查,并对发生适应不良者进行相应的心理干预或药物治疗。结果抗震救援组军人适应不良自评量表总分及其各因子分均高于非抗震救援组（P〈0．05）。抗震救援组军人适应不良自评量表总分与社会支持量表总分之间呈负相关（r=-0．43,P〈0．01）,即获得的社会支持越少,适应不良的发生率越高。影响抗震救援官兵适应不良的主要影响因素是社会支持和婚姻状况;心理和药物干预具有明显的效果,使99．3％出现适应不良的官兵中有93．1％的心理障碍者完全缓解。结论参加抗震救援官兵出现明显的适应不良,而良好的社会支持和有效的干预措施,可减少适应不良的发生。     

四肢地震伤的影像诊断价值

目的探讨四肢地震伤的影像诊断价值。方法103例四肢地震伤患者均行X线平片检查,其中28例行CT检查,5例行MRI检查。结果经影像学检查明确四肢骨骨折81例,其中单发骨折34例,多发骨折47例;开放性骨折6例,闭合性骨折75例。关节脱位7例,软组织内异物5例,膝关节半月板损伤1例,气性坏疽1例。结论影像学检查有利于四肢地震伤的及时准确诊断和治疗方式的选择。     

单臂外固定支架治疗地震致胫腓骨骨折152例

目的探讨单臂外固定支架在治疗地震致胫腓骨骨折中的临床应用效果。方法对152例地震致胫腓骨骨折患者行一期闭合复位单臂外固定支架固定。结果单臂外固定支架对胫腓骨骨折治疗效果良好,固定可靠。结论该术式简便快捷,软组织损伤小,适合短时间内对大批胫排骨骨折伤员进行固定治疗,方便转运,利于二期进一步处理。     

地震后颅脑损伤患者20例临床分析

目的分析20例地震后颅脑损伤患者的临床特点和诊疗经验。方法对20例颅脑损伤患者从致伤方式,损伤类型,并发症情况及治疗经验等方面进行分析。结果地震后颅脑损伤患者合并损伤多,感染率高,内科并发症多,经多科联合治疗后均顺利康复。结论地震后颅脑损伤患者有其临床特点和转运指征,根据其特点进行多科联合治疗有助于患者的顺利康复。     

汶川地震中医院住院伤病员的营养干预

在汶川地震医疗救援中,华西医院营养科通过调整标准食谱、制订特殊饮食处方,为住院地震伤病员提供安全卫生的营养膳食,在此基础上再以整蛋白非要素膳为补充以满足伤病员对营养的需求;为危重、不能经口进食的伤病员提供个体化的全肠内营养支持方案并实施全肠内营养支持治疗;对住院伤病员进行营养宣教等一系列营养干预措施,不仅满足地震伤病员基本的营养需求,同时还为其疾病康复打下了坚实的基础。