脑损伤患者急性应激障碍的影响因素分析

目的 探讨脑损伤患者急性应激障碍的危险因素。方法 对2016年6月-2016年12月华北理工大学附属医院住院的脑损伤患者伴重度急性应激障碍患者172例、伴中度急性应激障碍的患者45例和无急性应激障碍脑损伤患者299例,采用斯坦福急性应激反应问卷(SASRQ)、匹兹堡睡眠质量指数量表(PSQI)和疼痛视觉模拟评分尺(VAS)和一般人口学资料对患者进行评测。结果 516例脑损伤患者SASRQ得分为(47.85± 25.872),多因素logistic回归分析显示,男性(OR=0.392,95%CI:0.245~0.628)、年龄小于45岁(OR=0.139,95%CI:0.076~0.256)、无偏瘫(OR=0.431,95%CI:0.264~0.704)、睡眠质量很好(OR=0.1654,95%CI:0.0712~0.384)是脑损伤患者急性应激障碍的保护因素(P＜0.05);需要药物辅助睡眠(OR=2.531,95%CI:1.611~3.975)、重度头痛(OR=6.417,95%CI:3.251~12.680)、是脑损伤患者急性应激障碍的危险因素(P＜0.05)。结论 脑损伤患者存在明显的急性应激障碍,严重头痛、偏瘫、睡眠质量差、需要药物辅助睡眠是脑损伤患者急性应激障碍的危险因素。

Analysis of the influencing factors of acute stress disorder among patients with brain injury

Objective To explore the risk factors of acute stress disorder in patients with brain injury.Methods We collected172 brain injury patients with acute stress disorder,45 brain injury patients with moderate stress disorder and 299 simple brain injury patients who hospitalized at North China University of Science and Technology affiliated hospital between May of 2016 and December of 2016,and the acute stress reactions were measured by using Stanford Acute Stress Reaction Questionnaire (SASRQ),Pittsburgh sleep quality index (PSQI) and visual analogue scale.Results Among the 516 brain injury patients,the average SASRQ score was 47.85±25.872.Multivariate logistic regression analysis showed that male(OR=0.392,95%CI:0.245~0.628),age less than 45 years old(OR=0.139,95%CI:0.076~0.256),no hemiplegic paralysis(OR=0.431,95%CI:0.264~0.704),good sleep quality(OR=0.1654,95%CI:0.0712~0.384) were protective factors of acute stress disorder in brain injury patients(P＜0.05).Drug poses no impacts on sleep(OR=2.531,95%CI:1.611~3.975),severe headache(OR=6.417,95%CI:3.251~12.680) are risk factors of acute stress disorder in brain injury patients (P<0.05).Conclusion In brain injury patients with acute stress disorder,severe headache,hemiplegic paralysis,poor sleep quality and drug poses no impacts on sleep are risk factors of acute stress disorder in brain injury patients.