汶川地震不同暴露因素下创伤后应激障碍程度的研究

目的 调查汶川地震后转移到重庆治疗的伤员,在不同暴露因素下出现创伤后应激障碍(Post-traumatic stress disorder,PTSD)症状的严重程度.方法 按多级整群抽样方法抽取转移到重庆市11所医院治疗的386名灾区伤员,采用PTSD-17项筛查问卷(PTSD Checklist-Civilian Version ,PCL-C)于地震后1个月对其进行回顾性问卷调查,回收有效问卷354份,分析不同暴露因素对PTSD症状严重程度的影响.结果 暴露于目睹地震中有人被掩埋、死亡及地震中被掩埋,接受手术因素下的伤员PTSD严重度总分分别为(44.64±11.86)分,(44.67±12.49)分,(45.96±12.1)分,(44.80±12.92)分,较未暴露者高,差异有显著性( P <0.01);多因素logistic回归分析显示暴露因素中地震中被掩埋(OR=2.171,95%CI1.088～4.333)为PTSD严重程度的高危因素.结论 暴露因素程度重者PTSD症状严重,被掩埋是PTSD症状严重程度的高危因素,更长时间内患PTSD可能性大;应对此类伤员实施有针对性的心理干预措施.

Different exposing factors on degree of post-traumatic stress disorder in victims of Wenchuan earthquake

Objective To investigate the severity of post traumatic stress disorder(PTSD) in victims of Wenchuan earthquake under different exposing factors. Methods One month after Wenchuan earthquake,354 wounded of distress area were collected from 11 hospitals of the Chongqing Municipality that received transferred wounded, according to multi-stage cluster sampling method. They were evaluated by PTSD Checklist-Civilian Version (PCL-C) and diagnostic tools,then analyzed the influencing factors of PTSD. Results The scores of victims who witnessed someone be buried,died and taken surgery were 44.64±11.86,44.67±12.49,45.96±12.1,44.80±12.92,higher than unexposed and had significant difference( P <0.01). Multinomial logistic regression analysis revealed those who were buried(OR=2.171, 95%CI:1.088～4.333)was high risk factor of severity of PTSD. Conclusion The more sever of exposing factor, the more sever of PTSD symptoms. Buried was highest among the six exposing factors. With time passed the possibility grew higher.Provide psychological intervention should be provided and be in for quite a long time to be concerned about.