骨肿瘤手术患者创伤后成长的调查研究

目的 探究骨肿瘤患者术后30 d创伤后成长（post-traumatic growth,PTG）水平及变化规律,以及与手术创伤后应激（post-traumatic stress,PTS）的相关性。 方法 采用方便抽样,选取2019年11月—2020年12月在四川省某三级甲等医院骨科病房住院的骨肿瘤手术患者作为调查对象,进行前瞻性队列研究。队列划分依据为患者术后2 d的中文版事件影响量表修订版得分,≥26分纳入PTS较大组,<26分纳入PTS较小组,评估其术后2、15、30 d PTG的水平。 结果 最终纳入PTS较小组78例,PTS较大组64例,共142例。全部患者术后2、15、30 d的中文版创伤后成长问卷（Chinese version of the Post traumatic Growth Inventory,PTGI-C）得分差异无统计学意义（F=2.704,P=0.069）。PTS较小组患者术后2、15、30 d的PTGI-C得分为（34.95±25.60）、（31.96±22.20）、（37.77±25.32）分;PTS较大组患者术后各时间点得分分别为（53.48±17.70）、（48.78±21.47）、（50.84±22.80）分,两组各时间点的PTG水平差异有统计学意义（F=27.029, P<0.001）。多元线性回归结果提示,术后2 d PTS对术后30 d PTG影响有统计学意义（β=0.272,P<0.05）。 结论 术后30 d 内PTG的最低点在术后15 d,该时间点医护人员应及时识别PTG较低的危险人群,并进行针对性干预。手术事件引起的PTS越强,PTG水平越高,二者呈正相关。

Study on the relationship between post-traumatic stress and post-traumatic growth in patients with bone neoplasms surgery

Objective To explore the post-traumatic growth（PTG） level and change of patients with bone neoplasms within 30 day after surgery,and the correlation with post-traumatic stress（PTS） after surgery. Methods A prospective cohort study was conducted by convenience sampling to select patients who met the criteria for inclusion and exclusion in the orthopedic ward of a tertiary hospital in Sichuan Province. The cohort was divided based on the scores of the revised version of Chinese translation of the Impact of Event Scale-Revised for patients 2 days after surgery. Patients whose scores were≥26 points would be included in the larger PTS group,and <26 points would be included in the smaller PTS group. Their PTG levels were assessed at 2nd day,15th day,and 30th day after surgery. Results In the end,a total of 142 cases were included. 78 cases were included in the smaller PTS group and 64 cases in the larger PTS group. The differences in PTGI-C scores of all patients at 2 d,15d and 30 d after surgery were no statistically significant. The PTGI-C scores of the patients in the smaller group of PTS were 34.95±25.60,31.96±22.20,and 37.77±25.32 at 2 d,15 d,and 30 d after the operation（F=2.704,P=0.069）. The scores of the patients in the larger PTS group at each time point after the operation were 53.48±17.70,48.78±21.47 and 50.84±22.80 points（F=27.029,P<0.001）. The difference in PTG levels between the 2 groups at each time point was statistically significant. Multiple linear regression results suggest that postoperative 2 d PTS has a statistically significant effect on postoperative 30 d PTG（β=0.272,P<0.05）. Conclusion The lowest point of PTG within 30 days after surgery is 15 days after surgery. Therefore,at this time,medical staff should promptly identify people at risk of reduced PTG and carry out targeted interventions. When the PTS caused by the surgical event gets stronger,the PTG level will be higher. There is a positive correlation between them.