轻、中度颅脑创伤患者早期症状群的分析研究

目的调查并分析轻中度颅脑创伤患者早期症状群的发生及分布情况。方法采用成人颅脑创伤症状自评量表以及90项症状自评量表(SCL-90)分别对颅脑创伤急性期治愈后拟出院患者及仅门诊就诊患者进行调查。使用主成分分析法(PCA)对全部颅脑创伤症状进行检验。结果自2012年9月至2013年9共收集到符合纳入标准病例132例,成人颅脑创伤症状自评量表经PCA分析显示存在4个症状群,分别命名为躯体化症状群,睡眠-情绪-认知症状群,神经行为症状群以及精力下降型症状群;SCL-90中颅脑创伤相关症状亚量表(BIS)经PCA分析后显示存在3个症状群,分别命名为躯体化症状群、精力下降型症状群以及情绪性症状群。其中稳定成群的症状有:头痛、头晕与注意力障碍;动力缺乏与思维迟缓。结论颅脑创伤后早期亦存在症状聚集成群的情况,颅脑创伤早期症状群的研究有助于理解症状的病理生理学特征,并能有针对性改善颅脑创伤后患者生活质量。

Analysis of the symptom clusters of mild-moderate traumatic brain injury in early stage

Objective The symptom clusters of mild-moderate traumatic brain injury （TBI） in early stage are investigated. Methods The brain injury patients at the time of discharging or merely referred to outpatient clinics for the first time were asked to rate their symptoms using the Traumatic Brain Injury Symptom Checklist for Adults （TBISC） and Symptom Checklist-90 （SCL-90）. Brain injury related symptoms in two questionnaires were analyzed for the presence of symptom clusters by utilizing a principal component analysis （PCA）. Results A total of 132 patients with mild-moderate brain injury met the criteria from September 2012 to September 2013. PCA supported a four-factor model in TBISC, namely somatization symptom cluster, sleep-mood-cognition symptom cluster, neurobehavioral disorders cluster and debility symptom cluster. While in Brain Injury Subscale （BIS） of SCL-90, three major factors were extracted by PCA, namely somatization symptom cluster, debility symptom cluster and mood disturbance symptom cluster. Although the constituents of the symptom clusters dramatically changed between two questionnaires, certain symptoms stably clustered included ： headaches, dizziness, and loss of attention and concentration ; lack of motivation and slowed mental processing. Conclusion Symptom clusters exist in patients with brain injury at the early stage. The study of early symptom clusters of brain injury will be helpful to understand the pathophysiological characteristics of symptoms and to specifically improve patients＇ quality of life following TBI.